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Boldis BV, Grünberger I, Cederström A, Björk J, Nilsson A, Helgertz J. Early Life Factors and Polycystic Ovary Syndrome in a Swedish Birth Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7083. [PMID: 37998314 PMCID: PMC10671095 DOI: 10.3390/ijerph20227083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a medical condition with important consequences for women's well-being and reproductive outcomes. Although the etiology of PCOS is not fully understood, there is increasing evidence of both genetic and environmental determinants, including development in early life. We studied a population of 977,637 singleton women born in in Sweden between 1973 and 1995, followed sometime between the age 15 and 40. The incidence of PCOS was measured using hospital register data during 2001-2012, complemented with information about the women's, parents' and sisters' health and social characteristics from population and health care registers. Cox regression was used to study how PCOS is associated with intergenerational factors, and a range of early life characteristics. 11,594 women in the study sample were diagnosed with PCOS during the follow-up period. The hazard rate for PCOS was increased 3-fold (HR 2.98, 95% CI 2.43-3.64) if the index woman's mother had been diagnosed with PCOS, and with 1.5-fold (HR 1.51, 95% CI 1.39-1.63) if their mother had diabetes mellitus. We found associations of PCOS with lower (<7) one-minute Apgar score (HR 1.19, 95% CI 1.09-1.29) and with post-term birth (HR 1.19, 95% CI 1.13-1.26). Furthermore, heavy (10+ cigarettes/day) maternal smoking (HR 1.30, 95% CI 1.18-1.44) and maternal obesity (HR 1.90, 95% CI 1.62-2.36) were strongly associated with PCOS. This study finds support for the heritability and fetal origins of PCOS. Risk of PCOS could be reduced by further emphasizing the importance of maternal and early life health.
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Affiliation(s)
- Beata Vivien Boldis
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden; (I.G.); (A.C.)
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Department of Laboratory Medicine, Lund University, 22100 Lund, Sweden; (J.B.); (A.N.)
- Centre for Economic Demography, School of Economics and Management, Lund University, 22100 Lund, Sweden;
| | - Ilona Grünberger
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden; (I.G.); (A.C.)
| | - Agneta Cederström
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden; (I.G.); (A.C.)
| | - Jonas Björk
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Department of Laboratory Medicine, Lund University, 22100 Lund, Sweden; (J.B.); (A.N.)
| | - Anton Nilsson
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Department of Laboratory Medicine, Lund University, 22100 Lund, Sweden; (J.B.); (A.N.)
- Centre for Economic Demography, School of Economics and Management, Lund University, 22100 Lund, Sweden;
| | - Jonas Helgertz
- Centre for Economic Demography, School of Economics and Management, Lund University, 22100 Lund, Sweden;
- Department of Economic History, Lund University, 22100 Lund, Sweden
- Institute for Social Research and Data Innovation, Minnesota Population Center, University of Minnesota, Minneapolis, MN 55455, USA
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Juber NF, Abdulle A, AlJunaibi A, AlNaeemi A, Ahmad A, Leinberger-Jabari A, Al Dhaheri AS, AlZaabi E, Mezhal F, Al-Maskari F, Alanouti F, Alsafar H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Weitzman M, Al-Houqani M, Hag-Ali M, Oumeziane N, El-Shahawy O, Sherman S, Shah SM, Loney T, Almahmeed W, Idaghdour Y, Ali R. Association between pediatric asthma and adult polycystic ovarian syndrome (PCOS): a cross-sectional analysis of the UAE healthy future Study (UAEHFS). Front Endocrinol (Lausanne) 2023; 14:1022272. [PMID: 37293507 PMCID: PMC10246854 DOI: 10.3389/fendo.2023.1022272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction Asthma and polycystic ovarian syndrome (PCOS) are linked in several possible ways. To date, there has been no study evaluating whether pediatric asthma is an independent risk factor for adult PCOS. Our study aimed to examine the association between pediatric asthma (diagnosed at 0-19 years) and adult PCOS (diagnosed at ≥20 years). We further assessed whether the aforementioned association differed in two phenotypes of adult PCOS which were diagnosed at 20-25 years (young adult PCOS), and at >25 years (older adult PCOS). We also evaluated whether the age of asthma diagnosis (0-10 vs 11-19 years) modified the association between pediatric asthma and adult PCOS. Material and methods This is a retrospective cross-sectional analysis using the United Arab Emirates Healthy Future Study (UAEHFS) collected from February 2016 to April 2022 involving 1334 Emirati females aged 18-49 years. We fitted a Poisson regression model to estimate the risk ratio (RR) and its 95% confidence interval (95% CI) to assess the association between pediatric asthma and adult PCOS adjusting for age, urbanicity at birth, and parental smoking at birth. Results After adjusting for confounding factors and comparing to non-asthmatic counterparts, we found that females with pediatric asthma had a statistically significant association with adult PCOS diagnosed at ≥20 years (RR=1.56, 95% CI: 1.02-2.41), with a stronger magnitude of the association found in the older adult PCOS phenotype diagnosed at >25 years (RR=2.06, 95% CI: 1.16-3.65). Further, we also found females reported thinner childhood body size had a two-fold to three-fold increased risk of adult PCOS diagnosed at ≥20 years in main analysis and stratified analyses by age of asthma and PCOS diagnoses (RR=2.06, 95% CI: 1.08-3.93 in main analysis; RR=2.74, 95% CI: 1.22-6.15 among those diagnosed with PCOS > 25 years; and RR=3.50, 95% CI: 1.38-8.43 among those diagnosed with asthma at 11-19 years). Conclusions Pediatric asthma was found to be an independent risk factor for adult PCOS. More targeted surveillance for those at risk of adult PCOS among pediatric asthmatics may prevent or delay PCOS in this at-risk group. Future studies with robust longitudinal designs aimed to elucidate the exact mechanism between pediatric asthma and PCOS are warranted.
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Affiliation(s)
- Nirmin F. Juber
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Abdishakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Abdulla AlJunaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Abdulla AlNaeemi
- Department of Cardiology, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Amar Ahmad
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences; United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Eiman AlZaabi
- Department of Pathology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Fatima Mezhal
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Fatme Alanouti
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Genetics and Molecular Biology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Juma Alkaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Laila Abdel Wareth
- Department of Laboratory Medicine, National Reference Laboratory, Abu Dhabi, United Arab Emirates
| | - Mai Aljaber
- Healthpoint Hospital, Abu Dhabi, United Arab Emirates
| | - Marina Kazim
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi & Al-Ain, United Arab Emirates
| | - Michael Weitzman
- Department of Environmental Medicine, New York University of Medicine, New York, United States
| | - Mohammed Al-Houqani
- Department of Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Mohammed Hag-Ali
- Faculty of Health Sciences, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates
| | - Naima Oumeziane
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi & Al-Ain, United Arab Emirates
| | - Omar El-Shahawy
- Department of Population Health, New York University School of Medicine, New York, United States
| | - Scott Sherman
- Department of Population Health, New York University School of Medicine, New York, United States
| | - Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Youssef Idaghdour
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Erdem Guzel E, Kaya N, Tektemur A, Ulker N, Yardimci A, Akkoc RF, Canpolat S, Ozan IE. Chronic effects of maternal tobacco-smoke exposure and/or α-lipoic acid treatment on reproductive parameters in female rat offspring. Syst Biol Reprod Med 2020; 66:387-399. [PMID: 32951465 DOI: 10.1080/19396368.2020.1815248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Prenatal tobacco-smoke exposure negatively affects the reproductive functions of female offspring and oxidative stress plays a major role at this point. Alpha-lipoic acid (ALA), well known as a biological antioxidant, has been used as a nutritional supplement and as a therapeutic agent in the treatment of certain complications during pregnancy. We aimed to investigate the effects of maternal tobacco-smoke exposure and/or ALA administration on puberty onset, sexual behavior, gonadotrophin levels, apoptosis-related genes, apoptotic cell numbers and oxidative stress markers in the adult female rat offspring. Sprague-Dawley rats were divided into four groups; control, tobacco smoke (TS), TS+ALA and ALA groups. Animals were exposed to TS and/or ALA for 8 weeks before pregnancy and throughout pregnancy. All treatments ended with birth and later newborn female rats were selected for each experimental group. The experiment ended at postnatal day 74-77. Maternal tobacco smoke advanced the onset of puberty in the female offspring of the TS group (p < 0.05). In all treatment groups; the mean number of anogenital investigations and lordosis quality scores showed a decline, serum luteinizing hormone levels significantly increased (p < 0.05) and several histopathological changes in ovaries were observed compared to the control group. In addition, an increase in apoptotic marker levels and apoptotic cell numbers was detected in the ovaries of all treatment groups. Decreased TAS and increased TOS levels were detected in all treatment groups compared to control. These findings suggested that maternal tobacco smoke and/or ALA administration may be leading to the impaired reproductive health of female offspring. Abbreviations: ALA: alpha-lipoic acid; LH: luteinizing hormone; FSH: follicle-stimulating hormone; TAS: total antioxidant status; TOS: total oxidant status; Apaf1: apoptotic protease-activating factor 1; Casp3: caspase 3; Casp9: caspase 9; CF: cyst follicles; 4-HNE: 4-Hidroxynonenal; 8-OHdG: 8-hydroxydeoxyguanosine; TUNEL: terminal deoxynucleotidyl transferase-mediated deoxyuridine-biotin nick end labeling; ROS: reactive oxygen species; GnRHR: gonadotropin-releasing hormone receptor; HPG: hypothalamic-pituitary-gonadal; AMPK: AMP-activated protein kinase; ELISA: enzyme-linked immunosorbent assay; cDNA: complementary DNA; qPCR: quantitative real-time PCR; FC: follicular cysts; PF: primary follicle; SF: secondary follicle; GF: graafian follicle; CL: corpus luteum; DF: degenerated follicle; AF: atretic follicle.
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Affiliation(s)
- Elif Erdem Guzel
- Department of Midwifery, Faculty of Health Sciences, Mardin Artuklu University , Mardin, Turkey
| | - Nalan Kaya
- Department of Histology and Embryology, Faculty of Medicine, Firat University , Elazig, Turkey
| | - Ahmet Tektemur
- Department of Medical Biology, Faculty of Medicine, Firat University , Elazig, Turkey
| | - Nazife Ulker
- Department of Physiology, Faculty of Medicine, Firat University , Elazig, Turkey
| | - Ahmet Yardimci
- Department of Physiology, Faculty of Medicine, Firat University , Elazig, Turkey
| | - Ramazan Fazil Akkoc
- Department of Anatomy, Faculty of Medicine, Firat University , Elazig, Turkey
| | - Sinan Canpolat
- Department of Physiology, Faculty of Medicine, Firat University , Elazig, Turkey
| | - Ibrahim Enver Ozan
- Department of Histology and Embryology, Faculty of Medicine, Firat University , Elazig, Turkey
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Braun M, Klingelhöfer D, Oremek GM, Quarcoo D, Groneberg DA. Influence of Second-Hand Smoke and Prenatal Tobacco Smoke Exposure on Biomarkers, Genetics and Physiological Processes in Children-An Overview in Research Insights of the Last Few Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3212. [PMID: 32380770 PMCID: PMC7246681 DOI: 10.3390/ijerph17093212] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 02/07/2023]
Abstract
Children are commonly exposed to second-hand smoke (SHS) in the domestic environment or inside vehicles of smokers. Unfortunately, prenatal tobacco smoke (PTS) exposure is still common, too. SHS is hazardous to the health of smokers and non-smokers, but especially to that of children. SHS and PTS increase the risk for children to develop cancers and can trigger or worsen asthma and allergies, modulate the immune status, and is harmful to lung, heart and blood vessels. Smoking during pregnancy can cause pregnancy complications and poor birth outcomes as well as changes in the development of the foetus. Lately, some of the molecular and genetic mechanisms that cause adverse health effects in children have been identified. In this review, some of the current insights are discussed. In this regard, it has been found in children that SHS and PTS exposure is associated with changes in levels of enzymes, hormones, and expression of genes, micro RNAs, and proteins. PTS and SHS exposure are major elicitors of mechanisms of oxidative stress. Genetic predisposition can compound the health effects of PTS and SHS exposure. Epigenetic effects might influence in utero gene expression and disease susceptibility. Hence, the limitation of domestic and public exposure to SHS as well as PTS exposure has to be in the focus of policymakers and the public in order to save the health of children at an early age. Global substantial smoke-free policies, health communication campaigns, and behavioural interventions are useful and should be mandatory.
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Affiliation(s)
- Markus Braun
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, D-60590 Frankfurt, Germany; (D.K.); (G.M.O.); (D.Q.); (D.A.G.)
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Sørensen S, Brix N, Ernst A, Lauridsen LLB, Ramlau-Hansen CH. Maternal age at menarche and pubertal development in sons and daughters: a Nationwide Cohort Study. Hum Reprod 2019; 33:2043-2050. [PMID: 30312405 DOI: 10.1093/humrep/dey287] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/31/2018] [Indexed: 12/19/2022] Open
Abstract
STUDY QUESTION Is maternal age at menarche associated with pubertal development in sons and daughters? SUMMARY ANSWER Maternal age at menarche was associated with pubertal development in both sons and daughters. WHAT IS KNOWN ALREADY Studies have shown that age at menarche is greatly inherited from mother to daughter, but it remains largely unknown to what extent age at menarche in mothers is associated with timing of puberty in sons. STUDY DESIGN, SIZE, DURATION In this population-based study we used data from the Puberty Cohort nested within the Danish National Birth Cohort. Live-born singletons aged 11 were followed from 2012 to 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS In total, 15 822 children (7697 sons and 8125 daughters) gave half-yearly information on puberty from the age of 11 years until full sexual maturity or 18 years of age through self-administrated questionnaires (participation rate 71%). Information on maternal age at menarche was reported by the mothers during pregnancy. Maternal age at menarche was used both as a continuous and as a categorical variable (earlier, same time or later than peers). A multivariable regression model for interval-censored data was used. MAIN RESULTS AND THE ROLE OF CHANCE Maternal age at menarche was positively associated with timing of genital development, pubic hair development, first ejaculation of semen, voice break, axillary hair development and acne in sons, and with timing of breast development, pubic hair development, menarche, axillary hair development and acne in daughters. In sons, the associations were of similar strength for all pubertal markers, whereas in daughters, the associations were strongest for breast development and menarche. LIMITATIONS, REASONS FOR CAUTION Age at menarche was recalled during pregnancy. However, studies indicate that age at menarche is recalled moderately in adulthood. Information on puberty was self-reported, but inaccuracy of data would probably cause non-differential misclassification. WIDER IMPLICATIONS OF THE FINDINGS Early maternal age at menarche was associated with earlier pubertal development, and late maternal age at menarche was associated with later pubertal development in both sons and daughters. The largest effect-estimates were for the associations between maternal age at menarche and the daughters' age at menarche and age at breast development. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the Danish Council for Independent Research (4183-00152). There are no competing interests. TRIAL REGISTERATION NUMBER N/A.
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Affiliation(s)
- S Sørensen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus C, Denmark
| | - N Brix
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus C, Denmark
| | - A Ernst
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus C, Denmark
| | - L L B Lauridsen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus C, Denmark
| | - C H Ramlau-Hansen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus C, Denmark
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Jung EM, Kim HS, Park H, Ye S, Lee D, Ha EH. Does exposure to PM 10 decrease age at menarche? ENVIRONMENT INTERNATIONAL 2018; 117:16-21. [PMID: 29704753 DOI: 10.1016/j.envint.2018.04.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/15/2018] [Accepted: 04/15/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND There has been a consistent decrease in age at menarche in South Korea. A potential risk factor for early menarche is exposure to particulate matter (PM), because endocrine-disrupting compounds emitted into air from anthropogenic sources may be incorporated into PM. The objective of this study was to examine the association between pre-menarcheal exposure to PM ≤ 10 μm in diameter (PM10) and age at menarche in adolescents of South Korea using Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012 data. METHODS We used self-reported age at menarche of 639 girls aged 13-17 years in this study. The cut-off age for early menarche was set to 12 years. Based on each subject's address, 1-year, 2-year, and 3-year averages of annual mean PM10 concentrations (models 1-3) were linked to KNHANES. Models were adjusted for body mass index (BMI), city size, household income level, maternal age at menarche, and second-hand smoke exposure at home. SURVEYREG and SURVEYLOGISTIC procedures were used to address the complex survey design of KNHANES. RESULTS Overall analysis showed that exposure to PM10 has a significant effect on decreasing age at menarche. Multiple linear regression results suggested that each 1 μg/m3 increase in 1-year, 2-year, 3-year averages of annual mean PM10 concentrations accelerated age at menarche by 0.046 years (95% CI: -0.064, -0.027; p < .0001), 0.038 years (95% CI: -0.059, -0.018; p = 0.0003),and 0.031 years (95% CI: -0.047, -0.015; p = 0.0002), respectively. Adjusted ORs for a 1 μg/m3 increase in PM10 concentration were 1.08 (95% CI: 1.04 -1.12) for model 1, 1.06 (95% CI: 1.02 -1.10) for model 2, and 1.05 (95% CI: 1.01 -1.09) for model 3. CONCLUSION Our findings suggest that elevated PM10 concentration can decrease age at menarche. This is the first study that investigates the association between exposure to PM10 and age at menarche using a nationally representative sample of Koreans.
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Affiliation(s)
- Eun Mi Jung
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Ewha Global Health Institute for Girls, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hae Soon Kim
- Ewha Global Health Institute for Girls, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Shinhee Ye
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Dongheon Lee
- Department of Statistics, Williams College, Williamstown, MA, United States
| | - Eun Hee Ha
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Ewha Global Health Institute for Girls, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
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Valgeirsdottir H, Vanky E, Sundström-Poromaa I, Roos N, Løvvik TS, Stephansson O, Wikström AK. Prenatal exposures and birth indices, and subsequent risk of polycystic ovary syndrome: a national registry-based cohort study. BJOG 2018; 126:244-251. [PMID: 29896923 DOI: 10.1111/1471-0528.15236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To study the associations between prenatal exposures and risk of developing polycystic ovary syndrome (PCOS). DESIGN National registry-based cohort study. SETTING Sweden. POPULATION Girls born in Sweden during the years 1982-1995 (n = 681 123). METHODS The girls were followed until the year 2010 for a diagnosis of PCOS. We estimated the associations between maternal body mass index (BMI), smoking, and size at birth with the risk of developing a PCOS diagnosis. Risks were calculated by adjusted hazard ratio (aHR) and 95% confidence intervals (95% CIs). MAIN OUTCOME MEASURES A diagnosis of PCOS at 15 years of age or later. RESULTS During the follow-up period 3738 girls were diagnosed with PCOS (0.54%). Girls with mothers who were overweight or obese had 1.5-2.0 times higher risk of PCOS (aHR 1.52, 95% CI 1.36-1.70; aHR 1.97, 95% CI 1.61-2.41, respectively), compared with girls born to mothers of normal weight. The risk of PCOS was increased if the mother smoked during pregnancy (1-9 cigarettes/day, aHR 1.31, 95% CI 1.18-1.47; ≥10 cigarettes/day, aHR 1.44, 95% CI 1.27-1.64). Being born small for gestational age (SGA) was associated with a later diagnosis of PCOS in crude estimates, but the association was not significant after adjusting for maternal factors. CONCLUSIONS Maternal smoking and increased BMI appear to increase the risk of PCOS in offspring. The association between SGA and the development of PCOS appears to be mediated by maternal factors. TWEETABLE ABSTRACT Smoking during pregnancy and high maternal BMI are associated with PCOS diagnosis in the offspring.
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Affiliation(s)
- H Valgeirsdottir
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - E Vanky
- Department of Obstetrics and Gynaecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - I Sundström-Poromaa
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - N Roos
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden
| | - T S Løvvik
- Department of Obstetrics and Gynaecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - O Stephansson
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - A-K Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden
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8
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Houghton LC, Goldberg M, Wei Y, Cirillo PM, Cohn BA, Michels KB, Terry MB. Why do studies show different associations between intrauterine exposure to maternal smoking and age at menarche? Ann Epidemiol 2018; 28:197-203. [PMID: 29482744 DOI: 10.1016/j.annepidem.2018.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/13/2017] [Accepted: 01/08/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Studies suggests that intrauterine exposure to maternal smoking both accelerates or delays age at menarche. We hypothesize that these opposing findings relate to different infant and childhood growth patterns across cohorts. METHODS Using data from an adult follow-up study of the Child Health and Development Studies and the National Collaborative Perinatal Project, we examined, using generalized estimating linear regression models, whether intrauterine exposure to maternal smoking was associated with age at menarche in 1090 daughters before and after accounting for growth in weight. RESULTS Compared to the nonexposed, intrauterine exposure to maternal smoking was associated with a 4-month acceleration in menarche in the National Collaborative Perinatal Project (β = -0.35 years; 95% confidence interval [CI]: -0.63, -0.08), but a 6-month delay in menarche in the Child Health and Development Studies (β = 0.48 years; 95% CI: 0.13, 0.83), despite having a similar reduction in birth weight in both cohorts (∼300 g). The results were more consistent across cohorts when we stratified by postnatal growth patterns. For example, in those with rapid weight gain (increasing two growth references from 0 to 4 years), intrauterine exposure to maternal smoking was related to a 7-month acceleration in menarche (β = -0.56 years; 95% CI: -0.95, -0.17). CONCLUSIONS These findings suggest that the association of intrauterine exposure to maternal smoking on age at menarche depends on postnatal growth patterns.
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Affiliation(s)
- Lauren C Houghton
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY.
| | - Mandy Goldberg
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY
| | - Ying Wei
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, NY
| | - Piera M Cirillo
- The Center for Research on Women and Children's Health, The Child Health and Development Studies, Public Health Institute, Berkeley, CA
| | - Barbara A Cohn
- The Center for Research on Women and Children's Health, The Child Health and Development Studies, Public Health Institute, Berkeley, CA
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA; Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Germany
| | - Mary Beth Terry
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY; Herbert Irving Comprehensive Cancer Center, Columbia Medical Center, New York, NY
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