Abstract
There is emerging evidence demonstrating an association between maternal polycystic ovary syndrome (PCOS) and autism spectrum disorder (ASD) in children, however, the cumulative effect of maternal PCOS on the development of ASD or other neuropsychiatry disorders (NPD) in children and separately for males and females has not been examined. We sought to systematically evaluate the influence of maternal PCOS on a wide range of NPD including ASD, attention deficit hyperactivity disorder (ADHD), chronic tic disorder (CDT), other behavior disorders, anxiety, depression, bipolar disorder, schizophrenia in children as well as in women of reproductive age only. We queried electronic databases including PubMed, EMBASE, and Google Scholar, until March 2021. We used DerSimonian and Laird (D-L) random effects method to compute pooled effect size in terms of odds ratio (OR). Nineteen studies (1667851 mothers, 2260622 children) were included in this study. Mothers with PCOS had an increased odds of children diagnosed with ASD (OR = 1.40, p < 0.001), ADHD (OR = 1.42, p < 0.001), CTD (OR = 1.44, p = 0.001), anxiety (OR = 1.33, p < 0.001), as well as other behavioral symptoms (OR = 1.45, p < 0.001) in the adjusted analysis. The association between maternal PCOS and ASD (OR: 1.43 vs. 1.66), ADHD (OR: 1.39 vs. 1.54), and CTD (OR: 1.42 vs. 1.51) was found to be significantly consistent between males and females, respectively. Our data do not suggest increased fetal testosterone exposure is associated with increased autistic traits in children. However, PCOS was significantly associated with increased odds of a wide range of NPD in women themselves. Maternal PCOS is a risk factor for various NPD with a similar extent in their children regardless of their underlying comorbidities. Managing PCOS is essential for women’s health as well as for their children’s health. More research is needed to determine the mechanisms and links between maternal PCOS and NPD in children.
Highlights
Diagnosis and management of neuropsychiatric disorders (NPD) such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), chronic tic disorder (CTD), anxiety, and other behavioral disorders in the pediatric population are clinically challenging
We evaluated the influence of maternal polycystic ovary syndrome (PCOS) on the means, comorbidities and follow up years if any) (b) neuropsychiatric outcome separately and examined the association between fetal hyperan- characteristics
Available evidence based on pooled analyses suggests maternal PCOS is a risk factor for NPD in children independent of their sex and psychiatric comorbidities
Summary
Diagnosis and management of neuropsychiatric disorders (NPD) such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), chronic tic disorder (CTD), anxiety, and other behavioral disorders in the pediatric population are clinically challenging. These disorders are often undiagnosed or misdiagnosed in children and youth due to variations of signs and symptoms. This study did not assess the effect of maternal PCOS on the development of ASD in children using the analysis of cohort studies. The combined effect of maternal PCOS on the occurrence of various NPD other than ASD in children by combining data from individual studies has not been assessed in previous studies
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