MATERNAL POLYCYSTIC OVARY SYNDROME AND OFFSPRING HEALTH PLACENTAL AND EPIGENETIC CHANGES AND METABOLIC OUTCOMES

Abstract

Maternal polycystic ovary syndrome may be associated with offspring health through metabolic, placental, and epigenetic processes; however, shared familial factors and pregnancy characteristics complicate causal interpretation. This review aimed to compare clinical outcomes and placental and epigenetic findings while distinguishing human observations from experimental results. PubMed and Europe PMC were searched on November 2, 2026. The current synthesis was based on 11 full-text reports, with three additional reports considered on the basis of their abstracts. Risk of bias was assessed for individual comparisons, and certainty of evidence was assessed by outcome. An association with obesity at ages 10–16 years, differences in birth anthropometry, and differences in lipid profiles in a selected group of girls were identified; molecular signals varied across tissues, platforms, and maternal phenotypes and did not establish a causal pathway to disease in the child. An exploratory meta-analysis of unadjusted birth weight included two cohorts comprising 291 mother child pairs; the pooled mean difference was −106.85 g, with a 95% confidence interval from −872.19 to 658.49 g using the conservative Knapp–Hartung modification. A zero estimate of heterogeneity with two studies did not confirm homogeneity. A funnel plot and Egger’s test were not used because there were too few comparable studies; the findings support individual associations and mechanistic hypotheses but do not separate the total causal effect of the syndrome from the effects of maternal obesity, gestational diabetes, infertility treatment, and other factors.