Objectives: This study aimed to evaluate the impact of benign ovarian cyst size on maternal and neonatal outcomes by comparing pregnancies complicated by cysts of different diameters.Methods: In this retrospective cohort study, 266 pregnant women diagnosed with benign ovarian cysts were categorized into three groups according to cyst diameter: 10 cm.
Maternal characteristics, pregnancy complications, delivery outcomes, and neonatal parameters were analyzed. Composite adverse perinatal outcomes (CAPO) included prematurity, low Apgar scores, neonatal intensive care unit (NICU) admission, and neonatal morbidities.Results: Most small cysts ( 10 cm were associated with increased risks of preterm delivery (23.1%), composite adverse perinatal outcomes (26.9%), and higher incidences of torsion, rupture, and surgical intervention (P 10 cm carry a markedly higher likelihood of maternal complications and adverse perinatal outcomes, supporting closer surveillance and individualized, size-based management strategies.