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Women born small for gestational age at risk for PCOS
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American Society for Reproductive Medicine 65th Annual Meeting
Women who were born small for gestational age may be at increased risk for polycystic ovary syndrome during the reproductive period, new data suggest.
A prospective, longitudinal cohort study conducted by researchers in Brazil compared data from 51 women who were small for gestational age newborns (37 to 42 weeks) with 130 women who were adequate for gestational age newborns. Researchers performed pelvic ultrasounds and evaluated free androgen index, sex hormone-binding globulin and other hormones.
Women born small for gestational age had a higher prevalence of PCOS (32%) compared with those born adequate for gestational age (13.8%; RR=2.02; 95% CI, 1.27-3.21).
Menstrual irregularity (51% vs. 25.4%; P=.0012) and clinical or laboratory hyperandrogenism (41.2% vs. 22.3%; P=.01) were also more common in the small for gestational age newborn group compared with the adequate for gestational age newborn group. Further, sex hormone-binding globulin levels were reduced more among women born small for gestational age, but the reduction was not significant (SGA, 54.9; AIG, 63; P=.08).
No significant between-group differences were reported for ultrasound criterion (SGA, 37.2; AIG, 33.8%; P=.6), free androgen index (SGA, 5.7; AIG, 4.8; P=.2) and hormonal evaluation.
Researchers classified women with PCOS into four phenotypes based on 2003 Rotterdam criteria: PCOS; hyperandrogenism plus chronic anovulation; hyperandrogenism plus ultrasound criteria; and chronic anovulation plus ultrasound criteria. The researchers concluded that PCOS phenotypes did not differ between women born small for gestational age and women born adequate for gestational age (50% vs. 55.5%). - by Jennifer Southall
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There is a great deal of interest in the hypothesis that inadequate nourishment prenatally, which results in SGA babies, causes postnatal obesity and adverse metabolic changes due to epigenetic adaptations to the prenatally 'starved' state. This is a small study that tends to confirm this hypothesis, but the focus on PCOS may be a bit off the mark. The authors found some signs of androgen excess in the women born SGA, but did not find PCO morphology to be increased in the SGA group to any great extent. Confirmation and extension of these findings is needed before firmer conclusions can be made, but the immense amount of work involved in characterizing these women who were born SGA is to be admired.
– Nannette Santoro, MD
Director of the division of REI, Albert Einstein College of Medicine, Montefiore Medical Center
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