Infants of Women with Polycystic Ovary Syndrome have Lower Cord Blood Androstenedione and Estradiol Levels

Abstract

ABSTRACT Context Prenatal androgen excess can cause a phenocopy of polycystic ovary syndrome (PCOS) in mammals. Retrospective studies have suggested that girls at risk for PCOS have low birth weight and prospective studies have suggested an increased prevalence of small for gestational age offspring in women with PCOS. Objective To determine whether infants of women with PCOS have reduced birth weight or increased intrauterine androgen levels. Design Prospective case-control study. Participants Thirty-nine PCOS and 31 control women and their infants. Main outcome measures Birth weight and mixed cord blood testosterone, androstenedione (A), dehydroepiandrosterone, 17-hydroxyprogesterone, estradiol (E2), and dihydrotestosterone levels. Results Mean birth weight did not differ but there was a significant increase in the prevalence of large for gestational age infants in the PCOS group. Cord blood E2 and A levels were lower (p < 0.05) but testosterone:E2 ratios did not differ in female PCOS compared to control offspring. There was no difference in E2 and A levels in the male PCOS and control offspring. There was no difference in 17-hydroxyprogesterone or in other androgen levels in either male or female PCOS offspring compared to their respective control group. Conclusion Infants of women with PCOS were more likely to be large for gestational age. Female offspring of affected women have lower cord blood A levels; other cord blood androgen levels do not differ compared to female control offspring. Cord blood E2 levels are also significantly decreased in PCOS, without any difference in the testosterone:E2 ratio, suggesting decreased fetal or placental production of steroids.