Pregnancy, delivery, and neonatal outcomes among women with PCOS and endometriosis: a population database cohort

Purpose PCOS and endometriosis are independent risk factors for perinatal outcomes. Little research has evaluated the concomitant effects of these conditions, nor have studies been conducted on a population database. We sought to identify the pregnancy, delivery, and neonatal outcomes in women with polycystic ovary syndrome (PCOS) and endometriosis vs. PCOS without endometriosis.

A retrospective population-based cohort study was performed extracting data using ICD-9 codes from the HCUP-NIS Database from 2004 to 2014. Endometriosis in women with PCOS represented the study group (n = 163), and the remaining PCOS, non-endometriosis patients constituted the reference group (n = 14,719). Subjects were included once per delivery. Demographics were compared using chi-squared tests. Confounding effects in pregnancy outcomes were controlled using binary logistic regression analysis.

Concomitant endometriosis and PCOS patients were more likely to be white (88.5% vs.71.0%, p < 0.001), with BMI < 30 kg/m2 (87.1% vs.77.8%, p < 0.004) and from lower income quartiles (27.1% vs.17.1%, p < 0.017) when compared to PCOS without endometriosis. Comparing pregnancy complication rates, placental abruption (p < 0.018, aOR 3.01, 95% CI 1.21–7.50), Cesarean section (p < 0.003, aOR 1.75, 95% CI 1.21–2.53), deep venous thromboses (p < 0.002, aOR 74.31, 95% CI 4.57–1209.21), and venous thromboembolic events (p < 0.031, aOR 10.40, 95% CI 1.24–87.37), were increased in the study group compared to the reference group.

Women with PCOS and endometriosis were more likely to be white, of lower socioeconomic status, lean, and experience abruptio-placenta, cesarean deliveries, and venous thromboembolisms. Since little was previously known about the combined outcomes of PCOS and endometriosis, it is difficult to counsel patients on risks. Our findings can help clinicians manage pregnant PCOS patients with endometriosis to minimize complications such as abruptio placenta and VTE. Similar content being viewed by others Data availability The HCUP data are publicly available.

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Agency for Healthcare Research and Quality (US), Rockville Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Author information Authors and Affiliations Contributions S Ismail: project development, data analysis, manuscript writing and editing. C Majdell: manuscript writing and editing. A Badgheish: data collection, management, and analysis. H Baghlaf: data collection and management. M Dahan: manuscript editing, project development, acted as the senior author for this study. Corresponding author Ethics declarations Conflict of interest The authors have no relevant financial or non-financial interests to disclose. Ethical approval Not applicable. Consent to participate Informed consent was obtained from all individual participants included in the study. Consent to publish Not applicable. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Ismail, S., Majdell, C., Badgheish, A. et al. Pregnancy, delivery, and neonatal outcomes among women with PCOS and endometriosis: a population database cohort. Arch Gynecol Obstet 310, 1235–1243 (2024). https://doi.org/10.1007/s00404-024-07589-w Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-024-07589-w