Jul 19, 2022

Jake Remaly July 18, 2022 Children whose mothers have polycystic ovary syndrome (PCOS) have increased rates of hospitalization for various conditions, including asthma, pneumonia, and ear infection, a study of more than 1 million children shows. The associations were not particularly strong, according to the researchers. But they raise questions about the reasons for the increased risk and whether interventions like diet, exercise, or medications could lead to healthier outcomes for children whose mothers have PCOS. “The findings suggest that maternal PCOS may have a negative impact on offspring development, enough to lead to a measurable increase in the risk of childhood hospitalization,” study coauthor Nathalie Auger, MD, associate professor of epidemiology at University of Montreal, Montreal, Quebec, Canada, and colleagues reported in Human Reproduction. “They are minor differences, just enough that we can statistically identify them. They’re not something where everyone should be worrying at this point,” Auger told Medscape Medical News. Still, some of the hospitalizations, such as those related to infection or allergy, potentially could be prevented with earlier ambulatory care, so some degree of greater awareness among parents and clinicians may be warranted, she said. 13 Years of Follow Up PCOS — a reproductive disorder characterized by irregular periods, increased male hormones, and metabolic complications — affects some 10% of women. People with the condition are at increased risk for obesity , type 2 diabetes , and cardiovascular disease. Although prior research has shown that maternal PCOS may be associated with higher body mass index and attention deficit disorder in children, data on long-term childhood health outcomes have been limited, Auger’s group noted. To examine illness in children exposed to maternal PCOS, the investigators analyzed hospitalization rates for nearly 1.04 million children in Quebec between 2006 and 2020; 7160 of the children had mothers with PCOS. In all, 275,354 children were hospitalized during 13 years of follow up, including 2314 whose mothers had PCOS. Children exposed to PCOS were hospitalized at a rate of 68.9 per 1000 person-years — roughly 50% more often than the rate of 45.3 per 1000 person-years for children not exposed to maternal PCOS. In an analysis that adjusted for maternal characteristics, childhood hospitalization for any reason was 1.32 times more likely for children exposed to maternal PCOS. Hospitalizations linked to infectious diseases — such as for bronchitis , bronchiolitis , pneumonia, nephritis, otitis media , or meningitis — were 1.31 times more likely among children exposed to PCOS. Allergy-related hospitalizations, such as for allergic asthma and anaphylaxis , were 1.47 times more likely, according to the researchers. Metabolic hospitalizations were 1.59 times more likely. For gastrointestinal hospitalizations, the hazard ratio was 1.72. For central nervous system hospitalizations, it was 1.74. The associations were stronger in earlier childhood, and results were similar for boys and girls, the investigators reported. Hospitalizations for cardiovascular disease, musculoskeletal conditions, or malignancy were not increased. ‘Surprising’ Links “The findings are surprising in that some of the conditions that they showed increased risk for, like asthma and some infections, are not conditions that we think of as being typically associated with PCOS,” said Andrea E. Dunaif, MD, chief of the Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes and Bone Disease at Mount Sinai Health System, New York City, who was not part of the study team. Earlier studies of offspring of women with PCOS have suggested that children may be at increased risk for insulin resistance and obesity. Differences in genetics, intrauterine environments, patterns of healthcare use by women with PCOS, and behavioral factors like diet and how children are raised are variables that potentially could have contributed to the different hospitalization rates among children exposed to maternal PCOS, Auger said. “Everything is interconnected,” she said. The study was supported by a grant from the Canadian Institutes of Health Research. Auger has received a career award from the Fonds de Recherche du Québec-Santé. Dunaif has consulted for Novo Nordisk and Fractyl Laboratories (now Fractyl Health). Hum Reprod. Published online July 13, 2022. Full text.