Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
St Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway.
JAMA Netw Open. 2024 Aug 1;7(8):e2430543. doi: 10.1001/jamanetworkopen.2024.30543.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder, characterized by subfertility, increased risk of metabolic diseases, and pregnancy complications. Previous studies diverge regarding the association between maternal PCOS and newborn anthropometrics.
To explore the association between maternal PCOS and newborn anthropometrics and the modifying effects of maternal body mass index, PCOS phenotype, and gestational diabetes.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study followed up women from the first half of pregnancy to birth and combined data from 3 clinical trials of pregnant women with PCOS and a reference population consisting of participants in the Norwegian Mother, Father, and Child Cohort (MoBa) Study, with data from the Medical Birth Registry of Norway. The recruitment period for the clinical trials was between October 1, 2000, and August 31, 2017, and for MoBa, between July 1, 1999, and December 31, 2008. Participants included women with singleton pregnancies and live-born children. Data were analyzed from January 1 to June 15, 2023.
Maternal PCOS status.
Newborn birth weight, birth length, and head circumference as continuous variables and z scores, and ponderal index (calculated as the birth weight in grams × 100 divided by the birth length in centimeters cubed), placenta weight, and ratio of birth weight to placenta weight (BWPW).
The cohort included 390 pregnant women with PCOS (mean [SD] age, 29.6 [4.2] years) and 68 708 women in the reference group (mean [SD] age, 30.4 [4.5] years). Offspring in the PCOS group had lower birth weight, birth length, and head circumference than in the reference group offspring. The estimated mean differences in z scores were -0.26 (95% CI, -0.38 to -0.14) for birth weight, -0.19 (95% CI, -0.33 to -0.05) for birth length, and -0.13 (95% CI, -0.26 to -0.01) for head circumference. The PCOS group also had a lower ponderal index (-0.04 [95% CI, -0.07 to -0.004] g × 100/cm3) and placenta weight (-24 [95% CI, -43 to -5)] g), and higher BWPW ratio (0.4 [95% CI, 0.3 to 0.5]). The association between growth restriction and PCOS was more apparent when additionally adjusting for body mass index. Neither PCOS phenotype nor gestational diabetes diagnosis was associated with neonatal anthropometry in women with PCOS.
In this cohort of mother-infant pairs, maternal PCOS status was associated with lower birth weight, shorter birth length, and smaller head circumference in the offspring. This growth restriction was more pronounced when adjusting for BMI, providing insight into the association between PCOS and body mass index. The study contributed to the understanding of how PCOS affects the offspring.
多囊卵巢综合征（PCOS）是一种常见的内分泌疾病，其特征为生育能力降低、代谢性疾病风险增加以及妊娠并发症。先前的研究在母体 PCOS 与新生儿人体测量学之间的关联上存在分歧。
探讨母体 PCOS 与新生儿人体测量学之间的关联，以及母体体重指数、PCOS 表型和妊娠糖尿病的修饰作用。
设计、地点和参与者：本队列研究对孕妇进行了从妊娠早期到分娩的随访，并结合了多囊卵巢综合征孕妇的 3 项临床试验的数据和挪威母亲、父亲和儿童队列研究（MoBa）参考人群的数据，后者的数据来自挪威医学出生登记处。临床试验的招募期为 2000 年 10 月 1 日至 2017 年 8 月 31 日，MoBa 的招募期为 1999 年 7 月 1 日至 2008 年 12 月 31 日。参与者包括单胎妊娠和活产婴儿的孕妇。数据分析于 2023 年 1 月 1 日至 6 月 15 日进行。
母体 PCOS 状态。
新生儿出生体重、出生长度和头围作为连续变量和 z 评分，以及体重指数（出生体重×100 除以出生长度立方厘米）、胎盘重量和出生体重与胎盘重量的比值（BWPW）。
该队列包括 390 名患有 PCOS 的孕妇（平均[标准差]年龄为 29.6[4.2]岁）和 68708 名参考组的妇女（平均[标准差]年龄为 30.4[4.5]岁）。与对照组相比，PCOS 组的新生儿出生体重、出生长度和头围较低。出生体重、出生长度和头围的估计平均差异 z 评分分别为-0.26（95%置信区间，-0.38 至 -0.14）、-0.19（95%置信区间，-0.33 至 -0.05）和-0.13（95%置信区间，-0.26 至 -0.01）。PCOS 组的体重指数也较低（-0.04[95%置信区间，-0.07 至 -0.004]g×100/cm3）和胎盘重量（-24[95%置信区间，-43 至 -5]g），BWPW 比值较高（0.4[95%置信区间，0.3 至 0.5]）。当额外调整体重指数时，生长受限与 PCOS 之间的关联更为明显。无论是 PCOS 表型还是妊娠糖尿病诊断，在患有 PCOS 的女性中均与新生儿人体测量学无关。
在这项母婴对研究中，母体 PCOS 状态与后代的出生体重降低、出生长度缩短和头围减小有关。当调整 BMI 时，这种生长受限更为明显，这为 PCOS 与体重指数之间的关联提供了新的认识。该研究有助于理解 PCOS 如何影响后代。
