title: Maternal Polycystic Ovary Syndrome and Risk for Attention-Deficit/Hyperactivity Disorder in the Offspring.
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder, and boys are two to three times more likely to develop ADHD. Maternal polycystic ovary syndrome (PCOS), a common metabolic disorder associated with excess circulating androgens, has been associated with increased risk for autism spectrum disorder in the offspring. In this study, we aimed to investigate whether maternal PCOS increases the risk for ADHD in the offspring.
  
  
  METHODS
  We conducted a matched case-control study using health and population data registers for all children born in Sweden from 1984 to 2008. Maternal PCOS was defined by ICD-coded register diagnosis. The outcome of ADHD was defined as an ICD-coded register diagnosis of ADHD and/or registered prescription of medications to treat ADHD. A total of 58,912 ADHD cases (68.8% male) were identified and matched to 499,998 unaffected controls by sex and birth month and year.
  
  
  RESULTS
  Maternal PCOS increased the odds of offspring ADHD by 42% after adjustment for confounders (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.26-1.58). Exclusion of ADHD cases with comorbid autism spectrum disorder attenuated but did not explain the relationship (OR, 1.34; 95% CI, 1.18-1.52). The risk was somewhat elevated for ADHD with comorbid autism spectrum disorder (OR, 1.76; 95% CI, 1.37-2.26). The risk for ADHD was higher among obese mothers with PCOS (OR, 1.68; 95% CI, 1.31-2.17) and was highest among obese mothers with PCOS and other features of metabolic syndrome (OR, 2.59; 95% CI, 1.02-6.58).
  
  
  CONCLUSIONS
  This study provides evidence that maternal PCOS may subtly influence the neurodevelopment of the offspring, resulting in increased risk for neurodevelopmental disorders such as ADHD.
authors.affiliation: Centre for Epidemiology and Community Medicine, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Kosidou
authors.affiliation: Centre for Epidemiology and Community Medicine, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Dalman
authors.affiliation: Centre for Epidemiology and Community Medicine, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Linnea
authors.initials: L
authors.lastname: Widman
authors.affiliation: Division of Public Health Epidemiology, and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Arver
authors.affiliation: Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania; A.J. Drexel Autism Institute, Philadelphia, Pennsylvania.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Lee
authors.affiliation: Centre for Epidemiology and Community Medicine, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Magnusson
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Electronic address: renee.gardner@ki.se.
authors.forename: Renee M
authors.initials: RM
authors.lastname: Gardner
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000209:etiology; D000067877:Autism Spectrum Disorder / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012042:Registries / Q000706:statistics & numerical data*; D012306:Risk; D013548:Sweden / Q000453:epidemiology
keywords: Attention-deficit disorder with hyperactivity; Autism spectrum disorder; Comorbidity; Epidemiology; Matched case-control study; Polycystic ovary syndrome; Prospective study