ESHRE: Polycystic Ovary Syndrome Linked to Gestational Development
By Katrina Woznicki, MedPage Today Staff Writer
Reviewed by Robert Jasmer, MD; Assistant Professor of Medicine, University of California, San Francisco
June 22, 2005
Also covered by: BBC News
MedPage Today Action Points
Inform interested patients that polycystic ovary syndrome may be rooted in gestational development, including reduced fetal and placental growth and excess maternal weight.
Advise women that a strong association was found between a mother’s weight during late pregnancy and a daughter’s risk for menstrual irregularity, hirsutism, and weight gain.
COPENHAGEN, June 22-High maternal weight and reduced fetal growth may increase a daughter’s risk of developing polycystic ovary syndrome (PCOS) later in life, Australian investigators said today.
In a preliminary retrospective study of 414 girls born in the 1970s, the young women’s weight, menstrual irregularities, and hirsutism were positively associated with their mothers’ weight during pregnancy (p <0.05), the team reported at the European Society for Human Reproduction and Embryology meeting here. The women were born between 1973 and 1976 at Queen Elizabeth Hospital in Adelaide. When interviewed by the researchers, 5% were already diagnosed with PCOS, said researchers led by Michael Davies, M.D., a senior research fellow at the Research Centre in Reproductive Health at the University of Adelaide. Twenty-seven percent reported menstrual irregularities, and 19.9% had a Ferriman-Gallway score -- a measure of hirsutism -- of 8+. Analysis also found a pre-existing PCOS diagnosis was associated with a birth weight on average 196 grams less than that of women without the ovarian syndrome (p = 0.10). Among other findings, the researchers also reported that women who had ever used the contraceptive pill to manage menstrual irregularities were smaller at birth (p = 0.08), had thinner abdomens at birth (p = 0.08), and smaller head circumferences (p = 0.05). "Our data suggest that different developmental pathways are implicated in the overlapping symptoms of polycystic ovarian syndrome," Dr. Davies said. One potential pathway, Dr. Davis proposed, is that excess weight in the mother during late pregnancy may be associated with a greater risk for menstrual irregularity in the daughter. Excess maternal weight, he added, may also be associated with potential obesity and weight-related reproduction problems in the daughters. A second potential pathway, the researchers suggested, might involve reduced placental and fetal growth, which may contribute to the more severe symptoms of PCOS. "A fetus that has been affected by restricted growth is more likely to have problems with insulin metabolism in later life due to an underlying metabolic problem," Dr. Davies said. "Our findings," Dr. Davies added, "support the proposition that there is an inter-generational growth path leading to menstrual irregularity, while at the same time, other symptoms may be one of a number of consequences of restricted fetal growth." These data, though preliminary, support other research that has suggested PCOS may be rooted in gestational development, the team noted. Primary source: European Society for Human Reproduction and Embryology Source reference: European Society for Human Reproduction and Embryology annual meeting in Copenhagen, presented June 22, 2005. http://www.medpagetoday.com/OBGYN/Infertility/tb/1226