Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden.
Epidemiology, Population Studies and Infrastructures (EPI@LUND), Department of Laboratory Medicine, Lund University, 22100 Lund, Sweden.
Int J Environ Res Public Health. 2023 Nov 20;20(22):7083. doi: 10.3390/ijerph20227083.
Polycystic ovary syndrome (PCOS) is a medical condition with important consequences for women's well-being and reproductive outcomes. Although the etiology of PCOS is not fully understood, there is increasing evidence of both genetic and environmental determinants, including development in early life. We studied a population of 977,637 singleton women born in in Sweden between 1973 and 1995, followed sometime between the age 15 and 40. The incidence of PCOS was measured using hospital register data during 2001-2012, complemented with information about the women's, parents' and sisters' health and social characteristics from population and health care registers. Cox regression was used to study how PCOS is associated with intergenerational factors, and a range of early life characteristics. 11,594 women in the study sample were diagnosed with PCOS during the follow-up period. The hazard rate for PCOS was increased 3-fold (HR 2.98, 95% CI 2.43-3.64) if the index woman's mother had been diagnosed with PCOS, and with 1.5-fold (HR 1.51, 95% CI 1.39-1.63) if their mother had diabetes mellitus. We found associations of PCOS with lower (<7) one-minute Apgar score (HR 1.19, 95% CI 1.09-1.29) and with post-term birth (HR 1.19, 95% CI 1.13-1.26). Furthermore, heavy (10+ cigarettes/day) maternal smoking (HR 1.30, 95% CI 1.18-1.44) and maternal obesity (HR 1.90, 95% CI 1.62-2.36) were strongly associated with PCOS. This study finds support for the heritability and fetal origins of PCOS. Risk of PCOS could be reduced by further emphasizing the importance of maternal and early life health.
多囊卵巢综合征（PCOS）是一种对女性健康和生殖结局有重要影响的医学病症。尽管 PCOS 的病因尚未完全阐明，但越来越多的证据表明其与遗传和环境因素有关，包括在生命早期的发育。我们研究了一个由 1973 年至 1995 年间在瑞典出生的 977637 名单胎女性组成的人群，这些女性在 15 岁至 40 岁之间的某个时间点接受了随访。2001 年至 2012 年期间，通过医院登记数据来测量 PCOS 的发病率，并补充了来自人口和医疗保健登记处的女性、父母和姐妹健康和社会特征的信息。Cox 回归用于研究 PCOS 与代际因素以及一系列生命早期特征之间的关系。在研究样本中，有 11594 名女性在随访期间被诊断为 PCOS。如果指数女性的母亲被诊断患有 PCOS，则 PCOS 的发病风险增加 3 倍（HR 2.98，95%CI 2.43-3.64），如果其母亲患有糖尿病，则风险增加 1.5 倍（HR 1.51，95%CI 1.39-1.63）。我们发现 PCOS 与较低的（<7）1 分钟 Apgar 评分（HR 1.19，95%CI 1.09-1.29）和过期分娩（HR 1.19，95%CI 1.13-1.26）有关。此外，母亲重度吸烟（HR 1.30，95%CI 1.18-1.44）和母亲肥胖（HR 1.90，95%CI 1.62-2.36）与 PCOS 强烈相关。本研究支持 PCOS 的遗传性和胎儿起源。通过进一步强调母亲和生命早期健康的重要性，可能会降低 PCOS 的发病风险。
