Testosterone Levels in Third Trimester in Polycystic Ovary Syndrome: Odense Child Cohort

Glintborg, Dorte; Jensen, Richard Christian; Bentsen, Kristian Kirkelund; Schmedes, Anne; Brandslund, Ivan; Kyhl, Henriette Boye; Bilenberg, Niels; Andersen, Marianne

doi:10.1210/jc.2018-00889

Cited by 30 publications

(44 citation statements)

References 32 publications

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“…Women with PCOS have higher testosterone levels during pregnancy compared with women without PCOS. This finding is in line with previous studies in pregnant women with PCOS, in which high testosterone levels also in late pregnancy have been noted (Glintborg et al, 2018;Detti et al, 2019;Piltonen et al, 2019). In pregnancy, maternal testosterone levels depend mainly on the feto-placental unit.…”

Section: Discussionsupporting

confidence: 92%

“…Findings on the role of hyperandrogenism for the obstetric complications that women with PCOS may encounter are less conclusive, as these also seem to depend on PCOS phenotype and maternal ethnicity, but only a few high-quality studies have been published (Falbo et al, 2010;Palomba et al, 2010;Bahri Khomami et al, 2018). Women with PCOS have higher total testosterone and free androgen index during pregnancy (Glintborg et al, 2018;Valdimarsdottir et al, 2019), and testosterone levels are positively correlated with AMH levels (Detti et al, 2019;Piltonen et al, 2019;Valdimarsdottir et al, 2019). The specific role of testosterone in the development of obstetric and neonatal complications has been assessed in a relatively limited number of studies, but rarely in PCOS populations.…”

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confidence: 99%

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Pregnancy outcome in women with polycystic ovary syndrome in relation to second-trimester testosterone levels

Valdimarsdottir

Wikström

Kallak

et al. 2021

Reproductive BioMedicine Online

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Pregnancy outcome in women with polycystic ovary syndrome in relation to second-trimester testosterone levels

Valdimarsdottir

Wikström

Kallak

et al. 2021

Reproductive BioMedicine Online

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“…This increase in SHBG is paralleled by higher circulating total testosterone levels, keeping free testosterone within the normal range of non-pregnant women until 3 rd trimester (Bammann et al, 1980). In women with PCOS, free testosterone levels increase during 3 rd trimester, which result in higher levels of free testosterone in women with PCOS compared to controls (Bammann et al, 1980;Glintborg et al, 2018). Elevated testosterone levels during pregnancy in women with PCOS question the complete suppression of ovarian and adrenal activity during pregnancy in PCOS (Caanen et al, 2016;Kallak et al, 2017).…”

Section: Introductionmentioning

confidence: 98%

Anogenital distance in children born of mothers with polycystic ovary syndrome: the Odense Child Cohort

et al. 2019

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STUDY QUESTION Are higher testosterone levels during pregnancy in women with polycystic ovary syndrome (PCOS) associated with longer offspring anogenital distance (AGD)? SUMMARY ANSWER AGD was similar in 3-month-old children born of mothers with PCOS compared to controls. WHAT IS KNOWN ALREADY AGD is considered a marker of prenatal androgenization. STUDY DESIGN, SIZE, DURATION Maternal testosterone levels were measured by mass spectrometry at Gestational Week 28 in 1127 women. Maternal diagnosis of PCOS before pregnancy was defined according to Rotterdam criteria. Offspring measures included AGD from anus to posterior fourchette (AGDaf) and clitoris (AGDac) in girls and to scrotum (AGDas) and penis (AGDap) and penile width in boys and body composition (weight and BMI SD scores) at age 3 months. PARTICIPANTS/MATERIALS, SETTING, METHODS The study was part of the prospective study, Odense Child Cohort (OCC), and included mothers with PCOS (n = 139) and controls (n = 1422). The control population included women with regular menstrual cycles (<35 days) before conception and no signs of androgen excess (hirsutism and/or acne). MAIN RESULTS AND THE ROLE OF CHANCE AGD measures were comparable in offspring of women with PCOS compared to controls (all P > 0.2) despite significantly higher maternal levels of total testosterone (mean: 2.4 versus 2.0 nmol/l) and free testosterone (mean: 0.005 versus 0.004 nmol/l) in women with PCOS versus controls (both P < 0.001). In women with PCOS, maternal testosterone was an independent positive predictor of offspring AGDas and AGDap in boys. Maternal testosterone levels did not predict AGD in girls born of mothers with PCOS or in boys or girls born of women in the control group. LIMITATIONS, REASONS FOR CAUTION The diagnosis of PCOS was based on retrospective information and questionnaires during pregnancy. Women participating in OCC were more ethnically homogenous, leaner, more educated and less likely to smoke compared to the background population. Our study findings, therefore, need to be reproduced in prospective study cohorts with PCOS, in more obese study populations and in women of other ethnicities. WIDER IMPLICATIONS OF THE FINDINGS Our finding of the same AGD in girls born of mothers with PCOS compared to controls expands previous results of studies reporting longer AGD in adult women with PCOS. Our results suggest that longer AGD in adult women with PCOS could be the result of increased testosterone levels in puberty, perhaps in combination with weight gain. STUDY FUNDING/COMPETING INTEREST(S) Financial grants for the study were provided by the Danish Foundation for Scientific Innovation and Technology (09-067180), Ronald McDonald Children Foundation, Odense University Hospital, the Region of Southern Denmark, the Municipality of Odense, the Mental Health Service of the Region of Southern Denmark, The Danish Council for Strategic Research, Program Commission on Health, Food and Welfare (2101-08-0058), Odense Patient data Explorative Network, Novo Nordisk Foundation (grant no. NNF15OC00017734), the Danish Council for Independent Research and the Foundation for research collaboration between Rigshospitalet and Odense University Hospital and the Health Foundation (Helsefonden). There is no conflict of interest of any author that could be perceived as prejudicing the impartiality of the research reported.

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“…In agreement with these findings, women with PCOS often give birth to babies smaller for gestational age and pregnant women with the syndrome experience elevated androgen levels and placental dysfunction. 45,46 It is also known that adverse maternal environmental exposures can alter the fetal epigenome. 47 In the present study, we showed an altered expression of maternal imprinting genes not only in the 17NF placentae at E18.5 but also in both the fetal and adult 17NF ovaries.…”

Section: Discussionmentioning

confidence: 99%

Excess of ovarian nerve growth factor impairs embryonic development and causes reproductive and metabolic dysfunction in adult female mice

et al. 2020

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Testosterone Levels in Third Trimester in Polycystic Ovary Syndrome: Odense Child Cohort

Abstract: TT and FT levels were higher in third-trimester pregnant women with PCOS compared with controls. Separate reference interval for FT in women with PCOS should be considered.

Cited by 30 publications

References 32 publications

Pregnancy outcome in women with polycystic ovary syndrome in relation to second-trimester testosterone levels

Pregnancy outcome in women with polycystic ovary syndrome in relation to second-trimester testosterone levels

Anogenital distance in children born of mothers with polycystic ovary syndrome: the Odense Child Cohort

Excess of ovarian nerve growth factor impairs embryonic development and causes reproductive and metabolic dysfunction in adult female mice

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