Razavi Journal of Medicine

Razavi Journal of Medicine

Demographic, clinical, and lifestyle factors associated with polycystic ovary syndrome among women attending health centers in Mashhad, Iran (2017–2023): a cross-sectional study

Articles in Press

Document Type : Original Article

Authors
Elnaz Gasemi 1
Neda Atashgahi 1
Robab Latifnejad Roudsari 2
Sanaz solati sadati 3
Ehsan Mosa Farkhani 4
1 Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
2 Evidence-Based Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Acupuncture, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
10.30483/rjm.2026.254640.1556
Abstract
Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of reproductive-age women, affecting roughly 10% worldwide. The demographic, clinical, and lifestyle factors associated with PCOS in the Iranian population remain incompletely characterized, particularly at the population level.

Objectives: We aimed to characterize the demographic, clinical, and lifestyle factors associated with PCOS in a large Iranian population-based sample.

Methods: We conducted a cross-sectional, registry-based study using routinely collected data from 12,391 women aged 15–50 years (3,098 with PCOS and 9,293 without) who attended primary-care centers affiliated with Mashhad University of Medical Sciences between March 2017 and June 2023. Records were extracted from the Sina Electronic Health Record system. An ICD-10-CM code of E28.2 defined cases. Associations between candidate factors and PCOS were examined using χ² tests and multivariable logistic regression, reporting adjusted odds ratios (AOR) with 95% confidence intervals (CI).

Results: PCOS was most frequent among women aged 31–40 years (53.2% of cases; AOR 1.99, 95% CI 1.54–2.59 versus <20 years). Obesity was independently associated with PCOS (AOR 1.45, 95% CI 1.26–1.66), and 57.0% of cases were overweight or obese. Regular fast-food consumption raised the odds of PCOS both monthly (AOR 1.56, 95% CI 1.27–1.92) and weekly (AOR 1.41, 95% CI 1.25–1.59). Hypertension (AOR 1.72, 95% CI 1.38–2.15) and anemia (AOR 1.40, 95% CI 1.22–1.60) were also independently associated with PCOS. A history of abortion showed a dose-response pattern, with AORs rising from 1.35 (one abortion) to 1.63 (three or more).

Conclusion: In this large registry-based sample, PCOS was independently associated with several modifiable factors, obesity, frequent fast-food intake, and reproductive history—alongside coexisting hypertension and anemia. These findings support integrated preventive strategies centered on weight management, dietary modification, and comprehensive reproductive-health care. Because of the cross-sectional design, associations should not be interpreted as causal. Future research should employ longitudinal designs to clarify the causal pathways underlying these associations.
Keywords
polycystic ovary syndrome
obesity
lifestyle
reproductive health

Acknowledgments: The authors thank Mashhad University of Medical Sciences for financial support (grant no. 4022137). They are grateful to the participants and to the healthcare staff at Mashhad health centers for their time and commitment.


Availability of data and materials: The data supporting the findings of this study were used under license from Mashhad University of Medical Sciences and are not publicly available owing to confidentiality restrictions. They are available from the authors on reasonable request and with permission of Mashhad University of Medical Sciences.


Ethics approval and consent to participate: This study was performed in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.FHMPM.REC.1402.234). As a secondary analysis of existing de-identified data, the requirement for individual informed consent was waived by the ethics committee.


Consent for publication: Not applicable.


Competing interests: The authors declare no competing interests.


Funding: This study was financially supported by Mashhad University of Medical Sciences, Mashhad, Iran (grant no. 4022137). The funder had no role in the study design, data collection, analysis, interpretation, or manuscript preparation.


Authors' contributions: E.G. conducted the investigation, contributed to the methodology, performed the data analysis, and drafted the initial manuscript. N.A. contributed to data collection and investigation, prepared the visualizations, and provided critical review. R.L.R. contributed to interpretation of the results and critically revised the manuscript from a midwifery perspective. E.M.F. conceived and designed the study, supervised the methodology and project administration, and provided critical guidance throughout. All authors approved the final version and agree to be accountable for all aspects of the work.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 21 August 2026