A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Fall, 2018 | Number 4, Volume 32

New evidence points to significant connection between polycystic ovary syndrome, autism

New findings add to evidence that children of women with polycystic ovary syndrome (PCOS) are at increased risk for autism spectrum disorders (ASD). In addition, the findings indicate that women with ASD are at higher risk for developing PCOS, and that women with PCOS have higher odds of being diagnosed with autism. 

PCOS affects five to 15 percent of women of childbearing age. Women with PCOS overproduce androgens such as testosterone, which influence the development of male characteristics. 

In the new research, Adriana Cherskov and colleagues conducted three matched case-control studies using electronic health records from the United Kingdom. The studies investigated: 

• The risk of PCOS in women with autism 

• The risk of autism in women with PCOS 

• The odds of having a first-born child with autism for mothers with or without PCOS 

The researchers say their data show that “in the UK, women with autism have an approximately two-fold increase in risk for PCOS, and women with PCOS also had a two-fold increase in rates of autism.” Moreover, they say, “Women with PCOS had 35% increased odds of having a firstborn child with autism, after adjusting for comorbid maternal psychiatric diagnosis, metabolic conditions, and complications in childbirth.” 

The findings are consistent with previous research by Kyriaki Kosidou and colleagues (see ARRI Vol. 30, No. 4, 2016). Kosidou and coworkers performed a matched case-control study of more than 23,000 individuals with ASD and more than 208,000 controls matched by birth month and year, sex, and region of birth. In that study, the researchers concluded, “Maternal PCOS increased the odds of ASD in the offspring by 59%, after adjustment for confounders.” Children of mothers with both PCOS and obesity (which also raises androgen levels) had an even greater risk of being diagnosed with ASD. 

Carrie Allison, a coauthor of the new study, comments, “We need to think about the practical steps we can put in place to support women with PCOS as they go through their pregnancies. The likelihood is statistically significant but nevertheless still small, in that most women with PCOS won’t have a child with autism, but we want to be transparent with this new information.”


Citations

“Polycystic ovary syndrome and autism: A test of the prenatal sex steroid theory,” Adriana Cherskov, Alexa Pohl, Carrie Allison, Heping Zhang, Rupert A. Payne, and Simon Baron-Cohen, Translational Psychiatry, Vol. 8, No. 1, August 1, 2018. Address: Adriana Cherskov, Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK, [email protected]). 

—and—

 “Women with polycystic ovary syndrome more likely to have a child with autism,” news release, University of Cambridge, October 9, 2018.