The Potential Implications of a PCOS Diagnosis on a Woman's Long-Term Health Using Data Linkage

Context: The polycystic ovary syndrome (PCOS) is the commonest endocrine abnormality in women of reproductive age. Objective: To determine the rate of hospital admissions for women with PCOS in Western Australian population in comparison to women without PCOS. Design: A population-based retrospective cohort study using data linkage in a statewide hospital morbidity database system. Setting: All hospitals within Western Australia. Participants: A total of 2566 women with PCOS hospitalized from 1997-2011 and 25 660 randomly selected age-matched women without a PCOS diagnosis derived from the electoral roll. Main Outcome Measures: Hospitalizations by ICD-10-M diagnoses from 15 years were compared. Results: Hospitalizations were followed until a median age of 35.8 years (interquartile range, 31.0-39.9). PCOS was associated with more nonobstetric and non-injury-related hospital admissions (median, 5 vs 2; P < .001), a diagnosis of adult-onset diabetes (12.5 vs 3.8%), obesity (16.0 vs 3.7%), hypertensive disorder (3.8 vs 0.7%), ischemic heart disease (0.8 vs 0.2%), cerebrovascular disease (0.6 vs 0.2%), arterial and venous disease (0.5 vs 0.2% and 10.4 vs 5.6%, respectively), asthma (10.6 vs 4.5%), stress/anxiety (14.0 vs 5.9%), depression (9.8 vs 4.3%), licit/illicit drug-related admissions (8.8 vs 4.5%), self-harm (7.2 vs 2.9%), land transport accidents (5.2 vs 3.8%), and mortality (0.7 vs 0.4%) (all P < .001). Women with PCOS had a higher rate of admissions for menorrhagia (14.1 vs 3.6%), treatment of infertility (40.9 vs 4.6%), and miscarriage (11.1 vs 6.1%) and were more likely to require in vitro fertilization (17.2 vs 2.0%). Conclusion: PCOS has profound medical implications for the health of women, and health care resources should be directed accordingly.