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  • Cesta, Carolyn E.Karolinska Institutet (author)

Maternal polycystic ovary syndrome and risk of neuropsychiatric disorders in offspring : prenatal androgen exposure or genetic confounding?

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • Cambridge University Press,2020
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:oru-79502
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-79502URI
  • https://doi.org/10.1017/S0033291719000424DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:143609274URI
  • https://gup.ub.gu.se/publication/279319URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • BACKGROUND: Maternal polycystic ovary syndrome (PCOS) has been proposed as a model for investigating the role of prenatal androgen exposure in the development of neuropsychiatric disorders. However, women with PCOS are at higher risk of developing psychiatric conditions and previous studies are likely confounded by genetic influences.METHODS: A Swedish nationwide register-based cohort study was conducted to disentangle the influence of prenatal androgen exposure from familial confounding in the association between maternal PCOS and offspring attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASD), and Tourette's disorder and chronic tic disorders (TD/CTD). PCOS-exposed offspring (n = 21 280) were compared with unrelated PCOS-unexposed offspring (n = 200 816) and PCOS-unexposed cousins (n = 17 295). Associations were estimated with stratified Cox regression models.RESULTS: PCOS-exposed offspring had increased risk of being diagnosed with ADHD, ASD, and TD/CTD compared with unrelated PCOS-unexposed offspring. Associations were stronger in girls for ADHD and ASD but not TD/CTD [ADHD: adjusted hazard ratio (aHR) = 1.61 (95% confidence interval (CI) 1.31-1.99), ASD: aHR = 2.02 (95% CI 1.45-2.82)] than boys [ADHD: aHR = 1.37 (95% CI 1.19-1.57), ASD: aHR = 1.46 (95% CI 1.21-1.76)]. For ADHD and ASD, aHRs for girls were stronger when compared with PCOS-unexposed cousins, but slightly attenuated for boys.CONCLUSIONS: Estimates were similar when accounting for familial confounding (i.e. genetics and environmental factors shared by cousins) and stronger in girls for ADHD and ASD, potentially indicating a differential influence of prenatal androgen exposure v. genetic factors. These results strengthen evidence for a potential causal influence of prenatal androgen exposure on the development of male-predominant neuropsychiatric disorders in female offspring of women with PCOS.

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  • Öberg, Anna S.Karolinska Institutet (author)
  • Ibrahimson, AbrahamDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (author)
  • Yusuf, IkramDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (author)
  • Larsson, Henrik,1975-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden(Swepub:oru)hiln (author)
  • Almqvist, CatarinaKarolinska Institutet (author)
  • D'Onofrio, Brian M.Karolinska Institutet (author)
  • Bulik, Cynthia M.Karolinska Institutet (author)
  • Fernández de la Cruz, LorenaKarolinska Institutet (author)
  • Mataix-Cols, DavidKarolinska Institutet (author)
  • Landén, Mikael,1966Gothenburg University,Göteborgs universitet,Karolinska Institutet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry(Swepub:gu)xlandt (author)
  • Rosenqvist, Mina A.Karolinska Institutet (author)
  • Karolinska InstitutetDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (creator_code:org_t)

Related titles

  • In:Psychological Medicine: Cambridge University Press50:4, s. 616-6240033-29171469-8978

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