“Risk of Autism Spectrum Disorder in Descendants of Women With Gestational Diabetes and Polycystic Ovary Syndrome: A Systematic Review and Meta‐Analysis”

Some reports show that children exposed to hyperandrogenemia or hyperglycemic states in utero are more prone to be diagnosed with autism spectrum disorder (ASD). This systematic review and meta-analysis aim to assess the association between Polycystic Ovary Syndrome (PCOS) or gestational diabetes (GD) and ASD. A systematic review (1980-2023) in Web of Science, PubMed and Scopus, using specific search terms "gestational diabetes", "polycystic ovary syndrome," "neurodevelopmental disorder" and "autism spectrum disorder" was performed. Generic inverse-variance method was used to pool the adjusted or crude effect measures with a random-effects model. Results were presented as relative risk (RR) with 95% confidence interval (CI). Only studies from the northern hemisphere were found. All the articles evaluated the association between either GD (n = 16) or PCOS (8) and ASD separately. The overall analysis revealed that there is an increased risk of ASD in the offspring of women diagnosed with GD [RR = 1.23 (95% CI 1.13-1.34), n = 14] and in women diagnosed with PCOS [RR = 1.35 (95% CI 1.17-1.56), n = 6]. In a sensitivity analysis, the risk of ASD was particularly higher in mothers with GD and obesity. Although both GD and PCOS have been associated with ASD in offspring, studies in other geographical regions are needed. Future research should investigate how varying androgen levels in PCOS and the timing of GD diagnosis might influence the observed associations. Additional studies are needed to confirm these associations, address potential confounding variables, and explore whether these maternal conditions contribute directly or indirectly to autism risk.