Could elevated prenatal testosterone levels signal a link between PCOS and autism? That's the implication of a recent study published in the journal Translational Psychiatry. But does PCOS actually increase a woman's risk of having a child with an autism spectrum disorder? We've taken a closer look at the research to help answer this question.
PCOS at a Glance
According to the Office on Women's Health, polycystic ovarian syndrome, or PCOS, is a hormonal disorder that affects an estimated 1 in 10 women of reproductive age. Although its exact cause remains unclear, it appears to occur when a woman produces higher-than-normal amounts of androgens, including testosterone. Women with PCOS also tend to have high blood levels of insulin or actual insulin resistance. These factors can increase the likelihood of fertility problems, as well as trigger symptoms such as extra hair growth, acne and weight gain. Physicians often diagnose PCOS using a combination of physical exam, blood tests and pelvic ultrasound.
We know that PCOS can raise a woman's risk for certain conditions, including diabetes, sleep apnea, and high blood pressure and cholesterol. It has also been associated with elevated rates of miscarriage, gestational diabetes, preeclampsia, C-sections and other concerns related to pregnancy and childbirth. Little research, however, has been conducted on the potential link between PCOS and autism, until now.
The Latest Research on PCOS and Autism
For the study published in Translational Psychiatry, researchers conducted three matched case-control studies, using data from electronic health records obtained from the Clinical Practice Research Datalink in the United Kingdom between 1990 and 2014. For the first one, they examined the risk of PCOS in women with autism. The second looked at the risk of autism in women with PCOS. In the third, the researchers evaluated the rates of autism in first-born children of 8,588 women with PCOS, compared to 41,127 women without PCOS.
In the first two studies, the researchers found an increased prevalence of PCOS in women with autism and elevated rates of autism in women with PCOS. In the third study, they concluded that the odds of having a child with an autism spectrum disorder were significantly increased for women with PCOS, even after they adjusted for maternal psychiatric diagnoses, obstetric complications and maternal metabolic conditions.
Talking to Patients About a Potential PCOS and Autism Risk
These findings strongly suggest a connection between PCOS and autism. According to the study's authors, the results shed more light on the effects of prenatal testosterone on the developing fetal brain, and on that child's behavior later in life.
We still don't know whether PCOS causes autism, but the link is certainly intriguing. It provides clinicians with yet another reason to provide optimal treatment for PCOS, and to counsel patients with the condition about the possible risk — no matter how small — of the relationship between PCOS and autism.
