Association of SSc with risk of premature ovarian insufficiency: a retrospective cohort study

Abstract Objectives Premature ovarian insufficiency (POI) is linked to an elevated risk of premature mortality. Nonetheless, evidence regarding the risk associated with POI in SSc is deficient. This study aimed to evaluate the risk of POI in SSc, offering insights to advance clinical management strategies. Methods Data from the Collaborative EHR Network including 61 569 984 females were used in this study. Data on females with SSc and without SSc aged 20–40 worldwide from 2005 to 2022 were gathered. Propensity score matching (PSM) was used to match demographic characteristics, medication and comorbidities that may affect ovarian function to construct the SSc and matched non-SSc cohorts with a ratio of 1:1. The differences in incidents of POI between the two cohorts were compared. Results A total of 6417 female patients with SSc and 6417 matched individuals were included. The age of the SSc group was 31.9 ± 6.0 years. Patients with SSc were associated with an increased risk of POI compared with the control group [HR = 1.6, 95% CI (1.1–2.2), log-rank test P = 0.017]. This association was consistent across both white and black populations. Notably, the risk was especially increased for SSc aged 30–40 (HR = 1.8, 95% CI 1.2–2.8). Conclusions Our study indicates that SSc is associated with a 1.6 times higher risk of developing POI. It underscores the importance of early evaluation and ongoing surveillance of ovarian health to improve the quality of life in women with SSc.