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The association between hypothyroidism and perinatal outcomes in patients with polycystic ovary syndrome

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To compare pregnancy, delivery, and neonatal outcomes in patients with polycystic ovary syndrome (PCOS) with and without concomitant hypothyroidism.

Methods

A retrospective population-based cohort study including all women with an ICD-9 diagnosis of PCOS in the US between 2004 and 2014, who delivered in the third trimester or had a maternal death. We compared women with a concomitant diagnosis of hypothyroidism to those without. Women with hyperthyroidism were excluded. Pregnancy, delivery, and neonatal outcomes were compared between the two groups.

Results

Overall, 14,882 women met inclusion criteria. Among them, 1882 (12.65%) had a concomitant diagnosis of hypothyroidism, and 13,000 (87.35%) did not. Women with concomitant hypothyroidism, compared to those without, were characterized by increased maternal age (25.5% ≥ 35 years vs. 18%, p < 0.001, respectively), and had a higher rate of multiple gestations (7.1% vs. 5.7%, p = 0.023). Interestingly, pregnancy, delivery and neonatal outcomes were comparable between the groups, except for a higher rate of small-for-gestational-age (SGA) neonates in the group with hypothyroidism (4.1% vs. 3.2%, p = 0.033) (Tables 2 and 3). In a multivariate logistic regression adjusting for potential confounders, hypothyroidism was no longer found to be associated with SGA (adjusted odds ratio [aOR] 1.32, 95% confidence interval [CI] 0.99–1.75, p = 0.057), but was found to increase the odds for preeclampsia (aOR 1.30, 95% CI 1.06–1.59, p = 0.012).

Conclusions

In patients with PCOS, concomitant hypothyroidism significantly increases the risk for preeclampsia. Unexpectedly, other pregnancy complications commonly increased by hypothyroidism were not increased in women with PCOS, likely due to the inherent elevated baseline pregnancy risks of PCOS.

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Data availability

The data that support the findings of this study are available from the authors upon reasonable request.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, McGill University, 845 Rue Sherbrooke, O, Montreal, QC, 3HA 0G4, Canada

    Alyssa Hochberg, Haitham Baghlaf & Michael H. Dahan

  2. The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Alyssa Hochberg

  3. Department of Obstetrics and Gynecology, Western University, London, ON, Canada

    Ahmad Badeghiesh

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  1. Alyssa Hochberg
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by AH, AB, HB and MD. The first draft of the manuscript was written by AH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. AH – Protocol and project development; data selection and management; data analysis; manuscript writing and editing. AB—Protocol and project development; Data selection and management; data analysis; manuscript editing. HB—Protocol and project development; Data selection and management; data analysis; manuscript editing. MD—Protocol and project development; data selection and management; data analysis; manuscript writing and editing.

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Correspondence to Alyssa Hochberg.

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The authors have no relevant financial or non-financial interests to disclose.

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This study used exclusively publicly accessible, anonymized data; therefore, according to articles 2.2 and 2.4 of Tri-Council Policy Statement (2010), institutional review board approval was not required.

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Informed consent was waived due to the retrospective design of the study.

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Hochberg, A., Badeghiesh, A., Baghlaf, H. et al. The association between hypothyroidism and perinatal outcomes in patients with polycystic ovary syndrome. Arch Gynecol Obstet 308, 291–299 (2023). https://doi.org/10.1007/s00404-023-07063-z

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