High prevalence of polycystic ovary syndrome in women born small for gestational age.
BACKGROUND
There is evidence that intrauterine growth restriction, resulting in newborn girls that are small for gestational age (SGA), may be related to the onset of polycystic ovary syndrome (PCOS). Thus, we studied whether women born SGA have a higher prevalence of PCOS than women born appropriate for gestational age (AGA).


METHODS
This was a prospective birth cohort study of 384 women born at term between June 1, 1978, and May 31, 1979, in Ribeirão Preto, Brazil. After exclusion, 165 women effectively participated in this study, of whom 43 were SGA and 122 were AGA. The prevalence of PCOS was analysed. At a mean age of 29 years, the women agreed to follow the study protocol, which included: anamnesis, physical examination, serum tests [follicle stimulating hormone, luteinizing hormone, total and free testosterone, dehydroepiandrostenedione sulphate, 17-OH-progesterone, fasting insulin, sex steroid-binding globulin (SHBG) and fasting glucose] and pelvic ultrasound. Data regarding gestational age, birthweight, age at menarche and maternal data were obtained from the files of the cohort. The adjusted relative risk (RR) values of the SGA, insulin resistance, body mass index, maternal smoking and parity variables were analysed using Poisson regression with robust adjustment of variance for the prediction of PCOS.


RESULTS
The prevalence of PCOS was higher in the SGA group than in the AGA group [adjusted RR = 2.44, 95% CI (1.39-4.28)]. Hyperandrogenism was more prevalent in the SGA women than in the AGA women (P = 0.011). Circulating SHBG was lower in the SGA women than in the AGA women (P = 0.041), but fasting insulinemia was similar in both groups.


CONCLUSIONS
The prevalence of PCOS in SGA women was twice as high as in AGA women in our study population.
Melo
A S
AS
Department of Obstetrics and Gynaecology, Medical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes 3900, Campus Universitário, Monte Alegre, CEP-14049-900, Ribeirão Preto, SP, Brazil.
Vieira
C S
CS
Barbieri
M A
MA
Rosa-E-Silva
A C J S
AC
Silva
A A M
AA
Cardoso
V C
VC
Reis
R M
RM
Ferriani
R A
RA
Silva-de-Sá
M F
MF
Bettiol
H
H
D000328:Adult; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D016012:Poisson Distribution; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors