Association of triglyceride‐glucose index and platelet‐to‐lymphocyte ratio with adverse pregnancy outcomes in women with polycystic ovary syndrome: A retrospective cohort study

Abstract Polycystic ovary syndrome (PCOS) increases the risk of adverse pregnancy outcomes (APOs) in pregnant women. Our cohort study evaluated the association between risk of APOs in a PCOS population and the triglyceride‐glucose (TyG) index and platelet‐to‐lymphocyte ratio (PLR). The cohort included 320 pregnant women, categorized into three groups based on PCOS and APOs: non‐APO‐PCOS ( n = 109), APO‐PCOS ( n = 107), and APO‐non‐PCOS ( n = 104). The APO‐PCOS group had significantly higher TyG indexes and PLRs compared to the non‐APO‐PCOS group. Logistic regression analyses revealed that assisted reproductive technology (ART) use, white blood cells (WBCs), PLR, total cholesterol, TyG index, and low‐density lipoprotein cholesterol (LDL‐C) were independent risk factors. After subgroup analysis based on gestational age, WBCs, PLR, TyG index, TC, and LDL‐C were positive indicators throughout pregnancy. Only family history of diabetes, body mass index, and ART use were associated with APO risk during the later stages of pregnancy. Further analysis confirmed a positive, nonlinear relationship between TyG index, PLR, and APO risk. Receiver operating characteristic analysis showed that the combination of both markers improved diagnostic accuracy. We conclude that the TyG index and PLR are associated with an increased risk of APOs in patients with PCOS. Monitoring these biomarkers during pregnancy offers novel perspectives for early identification in patients with high APO risk.