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Peer-reviewedCC BYAnnales d'Endocrinologie = Annals of Endocrinology

The tip of the iceberg: Morbidity in polycystic ovary syndrome in reproductive-age women

Abstract

CONTEXT: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-age women, but its true burden remains underestimated due to diagnostic variability and underreporting. OBJECTIVE: To estimate the morbidities in reproductive-age women identified with a diagnosis of PCOS in the French national health data system. METHODS: We conducted a retrospective cohort study using the French national health data system (SNDS) to identify reproductive-age women (18-43 years) diagnosed with PCOS (ICD-10 code E28.2) between 2014 and 2022. Morbidity data were assessed in 2022 and compared with an age-matched control group of women without PCOS in the same year. Specific comorbidities were identified using a set of algorithms applied to the system's data and based on both ICD-10 codes and medical acts and drug use. Logistic regression models were used to compare comorbidity rates, with odds ratios adjusted for age and social deprivation. RESULTS: We identified 21,144 women with PCOS in the health data system. Median age was 35 years [IQR: 29-39]. Compared with the general female population, women with PCOS had significantly higher rates of infertility (adjusted odds ratio (aOR)=24.35), gestational diabetes (aOR=1.64), type 2 diabetes (aOR 14.71), pulmonary embolism (aOR=2.04), arterial hypertension (aOR 5.86), acute stroke (aOR= 2.39), cardioneurovascular disease (aOR 2.12) and psychiatric disorders (aOR=1.66). CONCLUSIONS: Given the high morbidity among women identified with PCOS on ICD-10 code E28.2, improved diagnostic algorithms are needed to better identify PCOS cases in health databases and assess their public health implications.

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BibTeX
@article{courbiere2026iceberg,
  title = {{The tip of the iceberg: Morbidity in polycystic ovary syndrome in reproductive-age women}},
  author = {Blandine Courbiere and Eugénie Micolon and Appoline Zimmermann and Pascal Auquier and Julie Berbis and Sandrine Loubière},
  journal = {Annales d'Endocrinologie = Annals of Endocrinology},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ando.2026.102598},
  url = {https://hal.science/hal-05828582v1},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The tip of the iceberg: Morbidity in polycystic ovary syndrome in reproductive-age women
AU  - Blandine Courbiere
AU  - Eugénie Micolon
AU  - Appoline Zimmermann
AU  - Pascal Auquier
AU  - Julie Berbis
AU  - Sandrine Loubière
PY  - 2026
DA  - 2026/10/21
JO  - Annales d'Endocrinologie = Annals of Endocrinology
DO  - 10.1016/j.ando.2026.102598
UR  - https://hal.science/hal-05828582v1
AB  - CONTEXT: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-age women, but its true burden remains underestimated due to diagnostic variability and underreporting. OBJECTIVE: To estimate the morbidities in reproductive-age women identified with a diagnosis of PCOS in the French national health data system. METHODS: We conducted a retrospective cohort study using the French national health data system (SNDS) to identify reproductive-age women (18-43 years) diagnosed with PCOS (ICD-10 code E28.2) between 2014 and 2022. Morbidity data were assessed in 2022 and compared with an age-matched control group of women without PCOS in the same year. Specific comorbidities were identified using a set of algorithms applied to the system's data and based on both ICD-10 codes and medical acts and drug use. Logistic regression models were used to compare comorbidity rates, with odds ratios adjusted for age and social deprivation. RESULTS: We identified 21,144 women with PCOS in the health data system. Median age was 35 years [IQR: 29-39]. Compared with the general female population, women with PCOS had significantly higher rates of infertility (adjusted odds ratio (aOR)=24.35), gestational diabetes (aOR=1.64), type 2 diabetes (aOR 14.71), pulmonary embolism (aOR=2.04), arterial hypertension (aOR 5.86), acute stroke (aOR= 2.39), cardioneurovascular disease (aOR 2.12) and psychiatric disorders (aOR=1.66). CONCLUSIONS: Given the high morbidity among women identified with PCOS on ICD-10 code E28.2, improved diagnostic algorithms are needed to better identify PCOS cases in health databases and assess their public health implications.
SN  - 0003-4266
SN  - 2213-3941
ER  -