University of Oulu

Paalanne, M., Vääräsmäki, M., Mustaniemi, S., Tikanmäki, M., Wehkalampi, K., Matinolli, H.-M., Eriksson, J., Järvelin, M.-R., Morin-Papunen, L., & Kajantie, E. (2021). Clinical and biochemical signs of polycystic ovary syndrome in young women born preterm. European Journal of Endocrinology, 185(2), 279–288.

Clinical and biochemical signs of polycystic ovary syndrome in young women born preterm

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Author: Paalanne, Marika1,2; Vääräsmäki, Marja1,2; Mustaniemi, Sanna1,2;
Organizations: 1Finnish Institute for Health and Welfare, Population Health Unit, Oulu and Helsinki, Finland
2PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics, and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
3Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4Research Center for Child Psychiatry, University of Turku, Turku, Finland
5INVEST Research Flagship, University of Turku, Turku, Finland
6Folkhälsan Research Center, Helsinki, Finland
7Department of General Practice and Primary Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
8Department of Obstetrics and Gynecology, National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore
9Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
10Imperial College, London, UK
11Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: Bioscientifica, 2021
Publish Date: 2021-08-20


Objective: It has been suggested that adverse early life exposures increase the risk of developing polycystic ovary syndrome (PCOS) in later life. We hypothesized that women born preterm would have more biochemical and clinical signs of PCOS than women born at term.

Design: The ESTER Preterm Birth Study participants were born in Northern Finland and identified from the Northern Finland Birth Cohort and the Finnish Medical Birth Register. Altogether, 74 women born very or moderately preterm (<34 gestational weeks, VMPT), 127 born late preterm (at 34–36 weeks, LPT), and 184 born full term (≥37 weeks, controls) were included in the analysis (mean age: 23.2 years).

Methods: We measured serum total testosterone and sex hormone-binding globulin (SHBG) and calculated the free androgen index (FAI). PCOS according to the clinical and biochemical signs was defined either as hirsutism and oligoamenorrhea (via questionnaire) or as oligoamenorrhea and elevated testosterone levels (>2.4 nmol/L).

Results: Women born VMPT/LPT exhibited 33.0% (8.7, 62.8)/16.4% (−2.0, 38.1) higher testosterone, 28.5% (5.3, 45.9)/24.1% (5.6, 38.9) lower SHBG levels, and 64.6% (19.4, 127.1)/42.5% (11.1, 82.9) higher FAI than controls after adjusting for age and recruitment cohort, maternal BMI, smoking, and pregnancy disorders, parental education, history of hypertension, diabetes, myocardial infarction or stroke, and subject’s birth weight s.d. Odds ratios for having PCOS were 1.67 (0.44, 6.23)/3.11 (1.26, 7.70).

Conclusions: Women born preterm have a more hyperandrogenic hormonal profile, and those born LPT are approximately three times more likely at risk to have PCOS compared to women born at term.

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Series: European journal of endocrinology
ISSN: 0804-4643
ISSN-E: 1479-683X
ISSN-L: 0804-4643
Volume: 185
Issue: 2
Pages: 279 - 288
DOI: 10.1530/EJE-20-1462
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: The ESTER study was supported by grants from the Academy of Finland (SALVE program for 2009–2012 and grants 127437, 129306, 130326, 134791, 263924 and 315690 to E K), the Emil Aaltonen Foundation, the European Commission (Framework 5 award QLG1-CT-2000-001643; to M R J and Horizon 2020 award 733280 RECAP Research for Children and Adults Born Preterm to E K), Norface DIAL 462-16-040 Award PremLife to E K, the Finnish Foundation for Pediatric Research, the Finnish Government Special Subsidiary for Health Sciences (evo), the Finnish Medical Society: Duodecim, the Jalmari and Rauha Ahokas Foundation, the Juho Vainio Foundation, the Novo Nordisk Foundation, the Signe and Ane Gyllenberg Foundation, the Sigrid Jusélius Foundation, the Jenny and Antti Wihuri Foundation, and the Yrjö Jahnsson Foundation. In addition, NFBC 1986 received financial support from the Academy of Finland (grants 175617, 173454, 24300269, and 24300217); EU FP7-ENV-2008-1-226534; USA/NIH/NHLBI 1-R01-HL087679-01; RFP-RM-06-008; NorFA (50847); Thule Institute (50925); Oulu University Hospital, Oulu, Finland (24301140) and the University of Oulu, Finland (24000692, 24500283).
EU Grant Number: (226534) ARCRISK - Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling
Copyright information: © The authors 2021. This work is licensed under a Creative Commons Attribution 4.0 International License.