Polycystic ovaries after precocious pubarche: relation to prenatal growth

Abstract

Background: In 1998, we revealed a sequence departing from prenatal growth restraint in girls and evolving, through precocious pubarche (PP) in mid-childhood, towards anovulatory and hyperinsulinaemic hyperandrogenism. The latter condition fulfilled the criteria for the diagnosis of polycystic ovary syndrome (PCOS), which was then defined independently of the presence of polycystic ovaries (PCOs). Since 2003, the diagnosis of PCOS has been extended by adding PCO as an alternative criterion. We verified longitudinally over 28 +or- 2 years the prevalence of PCO and its potential relationship to growth before birth in a group of post-PP women (n=14, mean age=28 years; body mass index=24.3 kg/m2) belonging to the original cohort of 35 girls in whom the PP-PCOS sequence was described.

Methods: Endocrine-metabolic variables, body composition (by dual-energy X-ray absorptiometry), carotid intima-media thickness (IMT) and ovarian morphology by transvaginal ultrasonography were assessed in all women.

Results: Post-PP women with a birthweight (BW) in the lowest quartile, when compared with post-PP women with a higher BW, had smaller ovaries (mean volume=4.0 versus 9.0 ml; P=0.004) and a much lower prevalence of PCO (0 versus 67%; P=0.006). The remaining variables were similar between BW subgroups.

Conclusions: The presence of a PCO morphology in women with a PP history was found to relate to prenatal growth. It would be of interest to verify whether a similar relationship exists in anovulatory and/or hyperandrogenic women without PP history.