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Pregnancy complications and endometrial cancer in women with polycystic ovarian syndrome: a Korean National Health Insurance Service study
  1. Ju Hee Kim1,
  2. Min Hyung Jung2,
  3. Nalae Moon1,
  4. Se Hwa Hong3 and
  5. Dae Ryong Kang4
  1. 1Department of Nursing, Kyung Hee University, Seoul, Korea
  2. 2Department of Obstetrics and Gynecology, Kyung Hee University, Seoul, Korea
  3. 3Department of Biostatics, Yonsei University, Wonju, Korea
  4. 4Precision Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
  1. Correspondence to Professor Dae Ryong Kang, Precision Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; dr.kang{at}yonsei.ac.kr

Abstract

Objective Polycystic ovarian syndrome is associated with diverse pregnancy related complications and endometrial cancer. However, research on the relationship between pregnancy complications and endometrial cancer in women with polycystic ovarian syndrome is scarce. We aimed to examine the association between gestational diabetes mellitus, pregnancy induced hypertension, and preterm birth and the risk of endometrial cancer in women with polycystic ovarian syndrome.

Methods We analyzed data from the National Health Information Database established by the Korean National Health Insurance Service between January 2002 and December 2019. We included women with gestational diabetes mellitus, pregnancy induced hypertension, preterm birth, and endometrial cancer from among the polycystic ovarian syndrome population. All conditions were diagnosed according to the Korean Informative Classification of Diseases, 10th revision codes. Age, area of residence, income, body mass index, waist circumference, total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides, fasting blood sugar, and creatinine levels were included as covariates in the multiple logistic regression analysis.

Results Of 467 221 women with polycystic ovarian syndrome included, 5099 had endometrial cancer. Age, residence, income, body mass index, waist circumference, total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides, fasting blood sugar, and creatinine levels differed significantly between the endometrial cancer and non-endometrial cancer groups (p≤0.001–0.032). Among the polycystic ovarian syndrome population, the odds ratios (ORs) of endometrial cancer were 1.50, 1.43, and 1.23 in women with a history of gestational diabetes mellitus, pregnancy induced hypertension, and preterm birth, respectively, compared with those without a history of these conditions (OR 1.50, 95% confidence interval (CI) 1.32 to 1.69, p<0.001; 1.43, 1.04 to 1.97, p=0.027; and 1.23, 1.05 to 1.45, p=0.011, respectively).

Conclusion Our results suggest that a history of pregnancy complications (gestational diabetes mellitus, pregnancy induced hypertension, and preterm birth) increases the risk of endometrial cancer in women with polycystic ovarian syndrome.

  • endometrial hyperplasia
  • endometrial neoplasms

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. No additional data are available.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. No additional data are available.

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Footnotes

  • Contributors JHK is responsible for the overall content as the guarantor. JHK, MHJ, and DRK developed the study concept, design, and methodology. NM, SHH, and DRK performed data curation, and SHH and DRK conducted the formal data analysis. JHK acted as the project administrator and was in charge of research funding acquisition. JHK, MHJ, and DRK validated the study data. JHK and NM wrote the original manuscript, and all authors reviewed and edited the manuscript.

  • Funding This study was supported by the National Research Foundation of Korea (NRF), which is funded by the Korean government (Ministry of Science, ICT) (grant No NRF-2021R1A2C4001788).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.