A new study shows a link between polycystic ovary syndrome, or PCOS, in moms and a diagnosis of autism in children. But is there anything you can do to prevent it?
If you are one of the five to ten percent of women who have polycystic ovary syndrome (PCOS), you might feel like you get all the bad luck—lack of ovulation that can make it hard to get pregnant, links to obesity and diabetes. And now, a new study published in the journal Molecular Psychiatry shows that the hormonal imbalance present with PCOS could raise the rate of autism spectrum disorder (ASD) in children. But although it's not exactly good news, the increase in risk is not enough to be a huge concern for moms; instead, it might actually help scientists to uncover the causes of autism in order to develop earlier and better treatments.
A hormonal link
Researchers looked at the Swedish health database to study children born over a 20-year period, including 24,000 with autism and 200,000 without. "We compared children who received a diagnosis of autism to those who did not in terms of how often their mothers were affected by PCOS," Renee Gardner, Ph.D., senior investigator on the study and an assistant professor in the Department of Public Health Sciences of the Karolinska Institutet in Stockholm, tells Fit Pregnancy. "We saw that mothers with PCOS had a 59 percent increased risk of having a child with autism compared to mothers without PCOS." This study is the first to show this connection.
The link between PCOS and autism may be found in the excess of androgens, hormones such as testosterone that are associated with male traits. The origins of autism are still a mystery to scientists, but one theory is that increased exposure to these sex hormones affects brain development. "Women with PCOS have increased levels of androgens in their bodies compared to women without PCOS, even during pregnancy," Gardner says. "One possibility [for the connection with autism] is that the increased levels of androgens in mothers with PCOS subtly influence the developing brain and nervous system." But she notes that "the link between early-life androgen exposure and risk for autism is still unclear."
Another possible reason for the increased risk of autism is metabolic changes in mothers with PCOS, like a tendency to weigh more, have insulin resistance and gestational diabetes. "We saw that the risk for autism increased if mothers were affected by both PCOS and obesity, and our previous studies have shown that increased [pregnancy] weight gain is associated with increased risk for autism," Garner says.
How to reduce your risk
Because we still don't know exactly what's behind the relationship between polycystic ovary syndrome and autism, "there aren't any medications or special interventions we can recommend to women with PCOS," Gardner says. "That being said, there are a number of things that all women can do to increase their chances of a healthy pregnancy that will likely provide an even greater benefit to women with PCOS. Some of the risk that we observed in our study could likely be reduced if women with PCOS aimed to begin pregnancy at a healthy weight and stuck closely to weight gain guidelines."
Although there's not a lot we can do yet to prevent autism, the results of this study could help scientists' understanding of ASD in order to better treat children who have it. "Children who are diagnosed earlier and receive earlier interventions tend to do better in school, and socially, as they grow older," Gardner says. "So we do hope that this finding will help identify some cases of ASD earlier if physicians and mothers with PCOS are aware of the increased risk."
But, Gardner doesn't think the recent rise in cases of PCOS is responsible for the parallel increase in autism diagnoses. "PCOS is relatively rare and the link that we observed was modest," she says. "It's important for women with PCOS to not worry extensively about their children's developmental milestones. Chances are that children born to a mother with PCOS will not develop autism."