Abstract

Abstract Study question Does polycystic ovary syndrome (PCOS) affect the metabolic characteristics of offspring in childhood? Summary answer Girls born to PCOS mothers had increased cholesterol (CHOL) and low-density lipoprotein cholesterol (LDL) levels, whereas boys had comparable CHOL and LDL levels to controls. What is known already Maternal PCOS status may negatively influence childhood growth, endocrine and metabolic function. The long-term impact of PCOS on children health is poorly understood. Current findings reported by previous studies are divergent. Propensity score matching can reduce bias where strong confounding by indication is expected. Study design, size, duration This was a cohort study including 223 singletons born to women with PCOS and 2326 singletons born to non-PCOS women. All offspring were conceived by in-vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI) from January 2001 to January 2018 in reproductive center of Women’s hospital, Zhejiang University, School of medicine. Growth and development parameters and metabolic parameters were collected at age 3-6 years in Follow-up center of Women’s hospital, Zhejiang University, School of medicine. Participants/materials, setting, methods We used the propensity score (PS) to match PCOS women and non-PCOS women in a 1:4 ratio. The variables in the PSM included maternal age at conception, paternal age at conception, maternal height, maternal preconception BMI, IVF or ICSI, fresh-embryo transfer (ET) or frozen-embryo transfer (FET), gender of offspring, age at follow-up, year of follow-up. The PCOS group consisted of 217 patients and the non-PCOS group consisted of 787 patients after PS matching. Main results and the role of chance Maternal preconception weight (58.3±0.6 vs. 56.0±0.2, P<0.001) and body mass index (BMI) (23.0±0.2 vs. 21.9±0.1, P<0.001) were significantly higher in mothers with PCOS before PS matching. After PS matching, parental demographic characteristics were similar between groups including maternal preconception weight and BMI. In PS matching cohort, the height, weight, BMI of children at age 3-6 years were comparable between PCOS group and non-PCOS group. Singletons born to PCOS women had significantly higher CHOL levels (4.43±0.05 vs. 4.29±0.01, P=0.013) and LDL levels (2.45±0.04 vs. 2.37±0.01, P=0.049) compared with non-PCOS group. Even though the girls had similar BMI in childhood between the two groups(15.26±0.15 vs.15.13±0.80, P=0.449), the girls born to PCOS women still exhibited elevated CHOL levels (4.52±0.08 vs. 4.33±0.04, P=0.024) and LDL levels (2.55±0.06 vs. 2.39±0.03, P=0.007). These differences in CHOL (4.34±0.07 vs. 4.26±0.04, P=0.196) and LDL levels (2.36±0.05 vs. 2.36±0.03, P=0.866) were not observed in male offspring between the two groups. Limitations, reasons for caution Mothers’ weight gain during pregnancy, offspring lifestyle were not available for this study. This was a study carried out in a single center and was therefore susceptible to bias. Further studies remain necessary to fully confirm these results. Wider implications of the findings Our results support CHOL and LDL lipid metabolism as two of the earliest metabolic abnormalities features of the female offspring born to PCOS women. These findings suggest that further studies are needed to investigate the potential mechanisms and long-term metabolic changes associated with these differences. Trial registration number not applicable

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