The associations of maternal polycystic ovary syndrome and hirsutism with behavioral problems in offspring

Maternal polycystic ovary syndrome is associated with offspring anxiety; maternal hirsutism is related to offspring attention-deficit/hyperactivity disorder, conduct disorder, and behavioral problems. Despite some diagnostic overlap, offspring behavioral results vary.

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Volume 113, Issue 2, Pages 435–443


Sonia L. Robinson, Ph.D., Akhgar Ghassabian, MD, Ph.D., Rajeshwari Sundaram, Ph.D., Mai-Han Trinh, B.S., Erin M. Bell, Ph.D., Pauline Mendola, Ph.D., Edwina H. Yeung, Ph.D.



To study the associations between maternal polycystic ovary syndrome (PCOS) and hirsutism with offspring attention-deficit/hyperactivity disorder (ADHD), anxiety, conduct disorder, and behavioral problems.


Prospective birth cohort study.


Not applicable.


A total of 1,915 mother–child dyads.



Main Outcome Measure(s)

Maternal report of offspring ADHD, anxiety, or conduct disorder diagnosis at 7 to 8 years; emotional symptoms, behavioral problems (including peer relationship, conduct, hyperactivity/inattention), and prosocial problems measured with the Strengths and Difficulties Questionnaire (SDQ) at 7 years.


Prevalence of PCOS and hirsutism were 12.0% and 3.9%; 84% of women with hirsutism had PCOS. After adjustment for sociodemographic covariates, prepregnancy body mass index, and parental history of affective disorders, children born to mothers with PCOS had higher risk of anxiety (adjusted risk ratio [aRR] 1.62; 95% confidence interval [CI], 1.02–2.57) and borderline emotional symptoms (aRR 1.66; 95% CI, 1.18–2.33) compared with children born to mothers without PCOS. The associations between maternal PCOS and offspring ADHD were positive but imprecise. Maternal hirsutism was related to a higher risk of children’s ADHD (aRR 2.33; 95% CI, 1.28–4.24), conduct disorder (aRR 2.54; 95% CI 1.18–5.47), borderline emotional symptoms, peer relationship problems, and conduct problems (aRRs 2.61; 95% CI, 1.69–4.05; 1.92; 95% CI, 1.16–3.17; and 2.22; 95% CI, 1.30–3.79, respectively).


Maternal PCOS was associated with offspring anxiety, and hirsutism was related to other offspring behavioral problems. These findings should be interpreted with caution as replication is needed in prospective cohort studies that assess PCOS and hirsutism diagnoses using medical records.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.