Maternal polycystic ovarian syndrome and early offspring development
Maternal polycystic ovarian syndrome and early offspring development
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DOI：
10.1093/humrep/dey087
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发表时间：
2018-07-01
影响因子：
6.1
通讯作者：
Yeung, Edwina H.
中科院分区：
文献类型：
--
作者：
Belli, Griffith A.;Sundaram, Rajeshwari;Yeung, Edwina H.
研究问题：母体多囊卵巢综合征（PCOS）是否与后代发育迟缓有关？总结回答：多囊卵巢综合征母亲的后代在年龄和阶段问卷（ASQ）上失败的风险更高。已知：越来越多的证据表明，多囊卵巢综合征母亲的后代可能由于潜在的高雄激素血症和胰岛素抵抗而有更高的发育障碍风险。研究设计、规模、持续时间：上州儿童研究是一项以人群为基础的前瞻性队列研究，研究对象是2008年至2010年出生于纽约州（不包括纽约市）的婴儿，最初旨在研究不孕症治疗对儿童发育的影响。儿童随访至36个月。在所有的，4453母亲完成了一个或多个发展筛选工具5388儿童（35.5%双胞胎）长达36个月的age. PARTICATENTS/MATERIALS，设置，方法：在我们的研究中，458名母亲（10.3%）报告了医疗保健提供者的诊断PCOS，以及相关的治疗，在基线研究问卷。父母在孩子4、8、12、18、24、30和36个月大时完成了关于孩子发育的ASQ，以评估精细运动、粗大运动、沟通、个人社会功能和解决问题的认知领域。我们使用广义线性混合模型来估计PCOS诊断和ASQ失败之间的比值比（OR），该比值比调整了母亲的年龄、种族、BMI、教育、婚姻状况、吸烟、饮酒、糖尿病、保险和多元化。（调整后的比值比（aOR）= 1.77; 95% CI：1.09，2.89），主要是由于女性单胎患者的风险较高（aOR = 2.23; 1.16，4.29）。与非PCOS母亲所生的双胞胎相比，PCOS母亲所生的双胞胎在沟通（aOR = 1.94; 1.19，3.18）和个人社会功能（aOR = 1.76; 1.12，2.77）领域失败的风险更高。与未患多囊卵巢综合征的妇女的后代相比，未接受多囊卵巢综合征治疗的妇女的后代与ASQ失败有更强的关联（aOR = 1.68; 0.95，2.75），而报告PCOS治疗的妇女的后代中的相关性（aOR = 1.16; 0.79，1.73）。局限性，预防原因：需要进一步研究以证实母体PCOS在早期后代发育中的作用，提供者验证PCOS诊断。如果得到证实，这些发现表明PCOS女性的后代可能会增加发育迟缓的风险。
STUDY QUESTION: Is maternal polycystic ovarian syndrome (PCOS) associated with developmental delays in offspring?SUMMARY ANSWER: Offspring of mothers with PCOS were at higher risk of failure on the Ages and Stages Questionnaire (ASQ).WHAT IS KNOWN ALREADY: There is growing evidence that offspring of mothers with PCOS may be at higher risk for developmental disorders due to potential exposure to hyperandrogenism and insulin resistance. Few studies exist regarding maternal PCOS and early childhood development in the USA.STUDY DESIGN, SIZE, DURATION: The Upstate KIDS Study is a population-based prospective cohort study of infants born between 2008 and 2010 in New York State (excluding New York City), originally designed to study-and finding no impact of-infertility treatment exposure on child development. Children were followed up to 36 months of age. In all, 4453 mothers completed one or more developmental screening instruments for 5388 children (35.5% twins) up to 36 months of age.PARTICIPANTS/MATERIALS, SETTING, METHODS: In our study, 458 mothers (10.3%) reported a healthcare provider's diagnosis of PCOS, as well as the related treatment received, on the baseline study questionnaire. Parents completed the ASQ on their child's development at 4, 8, 12, 18, 24, 30 and 36 months of age to assess fine motor, gross motor, communication, personal-social functioning and problem-solving cognitive domains. We used generalized linear mixed models to estimate odds ratios (OR) between PCOS diagnosis and failures in the ASQ adjusted for maternal age, race, BMI, education, marital status, smoking, alcohol consumption, diabetes, insurance and plurality.MAIN RESULTS AND THE ROLE OF CHANCE: Diagnosis of PCOS was associated with increased risk of the offspring failing the fine motor domain (adjusted odds ratio (aOR) = 1.77; 95% CI: 1.09, 2.89), largely driven by higher risk in female singletons (aOR = 2.23; 1.16, 4.29). Twins of mothers with PCOS had higher risk of failing the communication (aOR = 1.94; 1.19, 3.18) and personal-social functioning (aOR = 1.76; 1.12, 2.77) domains compared to twins born to mothers without PCOS. Compared to offspring of women without PCOS, offspring of women who reported receiving no treatment for their PCOS had a stronger association with failing the ASQ (aOR = 1.68; 0.95, 2.75) than the association among offspring of women who reported PCOS treatment (aOR = 1.16; 0.79, 1.73).LIMITATIONS, REASONS FOR CAUTION: Further study is needed to confirm the role of maternal PCOS in early offspring development with provider-validated diagnosis of PCOS.WIDER IMPLICATIONS OF THE FINDINGS: If confirmed, these findings suggest that offspring of women with PCOS may be at increased risk for developmental delay.