Children born to mothers with polycystic ovary syndrome (PCOS) have an increased risk of developing infections, allergies and other childhood illnesses before the age of 13, according to the largest study on this.
The study, which is published today (Thursday) in human reproduction , one of the world’s leading reproductive medicine journals, examined 1,038,375 children born in Quebec, Canada, between 2006 and 2020. Of these, 7,160 children were born to mothers with PCOS.
Researchers found that children of mothers with PCOS were 32% more likely to be admitted to hospital with various health conditions than children of mothers without PCOS. They were 31% more likely to be admitted for infectious diseases and 47% more likely to be admitted for allergy-related conditions, such as asthma.
The risk of hospitalization was increased for problems related to metabolism (up 59%), intestine (72%), central nervous system (74%) and ear (34%); it was also increased for respiratory problems, such as pneumonia (32%), and mental and behavioral problems (68%). There was no link with cancer, and there was little difference between boys and girls in the association of PCOS with hospitalization.
PCOS is a common disorder of the ovaries that can affect up to 10% of women of childbearing age. The main characteristics are irregular periods, high levels of androgen, a male hormone, which can cause excessive facial or body hair, and the ovaries may enlarge and contain fluid-filled sacs (follicles) that surround the eggs. . PCOS can make it difficult for women to get pregnant and can lead to weight gain, thinning hair, and oily skin or acne. Women with PCOS are at risk for obesity, type 2 diabetes, and heart and blood vessel disease. Several studies have shown links to pregnancy and childbirth problems, such as gestational diabetes, pre-eclampsia, and premature labor. However, the long-term effect of PCOS on offspring is poorly understood and has received little attention.
Dr Nathalie Auger, associate professor of epidemiology at the School of Public Health at the University of Montreal, Canada, who led the study, said: “These results fill a large gap in what we know about the long-term health of children whose mothers have PCOS. Primary care physicians and obstetricians should consider identifying women with PCOS before conception and offering early interventions such as weight management and strategies to help prevent problems such as diabetes and heart disease and vascular. Family physicians and pediatricians should consider monitoring children more closely after birth to minimize morbidity. Greater parental awareness can help improve outcomes in children.
As this is an observational study, it is not able to show that PCOS causes health problems in children, only that it is associated with them, and it cannot show what mechanisms may be involved. However, Dr Auger said: “Women with PCOS may have high levels of androgen and insulin resistance, which have been linked to placental problems, such as inflammation of the membrane surrounding the fetus. , tissue damage and impaired function of the placenta. These create a suboptimal environment in babies’ wombs, which could lead to impaired immune function and low-grade systemic inflammation.
She said genetic factors could also play a role, with the environment in the womb leading to changes in how certain genes work in offspring.
The researchers adjusted their findings to account for factors that could affect the results, such as the mothers’ other health conditions, age, parity, alcohol and tobacco use, and socioeconomic deprivation. They found that the associations between maternal PCOS and offspring health were not explained by fertility treatments, multiple births, preterm births, or the mothers’ other health problems.
The strengths of the study include its size and the fact that it assessed a wide range of infections, allergies and malignancies, as well as specific health issues such as respiratory, cardiovascular, metabolic, gastrointestinal, urinary, genital, musculoskeletal, central nervous system, auditory, ocular, mental and behavioral disorders.
Limitations include that the researchers used data from the Maintenance and Use of Data for the Study of Hospital Clientele repository, which contains discharge records for all hospitalized patients, meaning they only analyzed outcomes of children admitted to hospital. They could not identify women with mild PCOS who were never diagnosed or children with less severe conditions who were not treated in hospital. They also lacked data on ethnicity, education, body mass index before pregnancy, weight gain during pregnancy, physical activity, information on the use of medications such as metformin and the age of the fathers.
“We believe that further research is needed to determine whether effective management of maternal PCOS can reduce the risk of health problems in offspring and improve long-term health. We need to know whether exercise, dietary changes and medications can make a difference,” Dr. Auger said.
“In future work, we intend to examine pregnancy outcomes, as well as future outcomes of women with PCOS. These women may be at risk for developing cardiovascular disease or other health problems, and epidemiological research documenting this possibility is needed to help improve the management of these patients.
 “Association of PCOS with Offspring Morbidity: A Longitudinal Cohort Study”, by Shu Qin Wei et al. human reproduction log. doi:10.1093/humrep/deac154
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Association of PCOS with offspring morbidity: a longitudinal cohort study
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