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母源性多囊卵巢综合征与儿童 3 岁时的注意缺陷多动障碍:欧登塞儿童队列研究。

Maternal polycystic ovary syndrome and attention deficit hyperactivity disorder in offspring at 3 years of age: Odense Child Cohort.

机构信息

Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.

Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.

出版信息

Acta Obstet Gynecol Scand. 2021 Nov;100(11):2053-2065. doi: 10.1111/aogs.14259. Epub 2021 Sep 6.

Abstract

INTRODUCTION

Previous data suggested a link between maternal polycystic ovary syndrome (PCOS) and offspring attention deficit hyperactivity disorder (ADHD), which could be mediated by higher prenatal androgen exposure.

MATERIAL AND METHODS

The study was part of the prospective Odense Child Cohort and included 1776 pregnant women, 165 (9%) with PCOS and 1607 (91%) controls. ADHD symptoms at 3 years of age were defined using the parent-reported questionnaire Child Behavior Checklist/1.5-5 (scores >90th centile of Danish national standard). Maternal blood samples were collected in the third trimester measuring total testosterone by mass spectrometry, sex hormone-binding globulin, and calculated free testosterone. Offspring anogenital distance was measured at 3 months of age. Regression models were performed with presence of ADHD symptoms as the dependent variable and adjusted for maternal age, body mass index, parity, smoking status, educational level, and parental psychiatric diagnoses.

RESULTS

ADHD symptoms were present in 105/937 (11%) boys and 72/839 (9%) girls. In boys, maternal PCOS was positively associated with ADHD symptoms (unadjusted odds ratio [OR] 1.91, 95% CI 1.07-3.43, p = 0.03, adjusted OR 2.20, 95% CI 1.20-4.02, p = 0.01), whereas maternal PCOS was not associated with ADHD symptoms in girls. Maternal total testosterone, free testosterone, and offspring anogenital distance were not associated with higher risk of ADHD symptoms in the offspring.

CONCLUSIONS

Higher risk of ADHD in boys born of mothers with PCOS were not associated with maternal third-trimester testosterone levels or offspring anogenital distance.

摘要

简介

先前的数据表明,母体多囊卵巢综合征(PCOS)与后代注意缺陷多动障碍(ADHD)之间存在关联,这种关联可能是由更高的产前雄激素暴露介导的。

材料和方法

该研究是前瞻性的奥登塞儿童队列的一部分,共纳入了 1776 名孕妇,其中 165 名(9%)患有 PCOS,1607 名(91%)为对照组。3 岁时的 ADHD 症状通过父母报告的问卷《儿童行为检查表/1.5-5》(得分高于丹麦全国标准第 90 百分位数)来定义。在孕晚期采集母亲血液样本,通过质谱法测量总睾酮、性激素结合球蛋白和计算的游离睾酮。在 3 个月大时测量后代的阴户到肛门距离。将 ADHD 症状的存在作为因变量进行回归模型分析,并调整了母亲的年龄、体重指数、产次、吸烟状况、教育程度和父母的精神科诊断。

结果

105/937(11%)名男孩和 72/839(9%)名女孩出现了 ADHD 症状。在男孩中,母体 PCOS 与 ADHD 症状呈正相关(未经调整的优势比[OR]1.91,95%可信区间[CI]1.07-3.43,p=0.03,调整后的 OR 2.20,95%CI 1.20-4.02,p=0.01),而母体 PCOS 与女孩的 ADHD 症状无关。母亲的总睾酮、游离睾酮和后代的阴户到肛门距离与后代患 ADHD 症状的风险增加无关。

结论

患有 PCOS 的母亲所生男孩患 ADHD 的风险增加与母亲孕晚期的睾酮水平或后代的阴户到肛门距离无关。

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