Clinical review: Identifying children at risk for polycystic ovary syndrome

J Clin Endocrinol Metab. 2007 Mar;92(3):787-96. doi: 10.1210/jc.2006-2012. Epub 2006 Dec 19.


Context: Polycystic ovary syndrome (PCOS) appears to arise as a complex trait with contributions from both heritable and nonheritable factors. Polygenic influences appear to account for about 70% of the variance in pathogenesis. In view of this evidence for congenital contributions to the syndrome, childhood manifestations may be expected.

Objective: The objective has been to review the evidence that risk factors for PCOS can be recognized in childhood.

Design: This study consisted of screening of the PCOS literature for articles pertaining to potential childhood and adolescent antecedents.

Results: Congenital virilizing disorders; above average or low birth weight for gestational age; premature adrenarche, particularly exaggerated adrenarche; atypical sexual precocity; or intractable obesity with acanthosis nigricans, metabolic syndrome, and pseudo-Cushing syndrome or pseudo-acromegaly in early childhood have been identified as independent prepubertal risk factors for the development of PCOS. During adolescence, PCOS may masquerade as physiological adolescent anovulation. Asymptomatic adolescents with a polycystic ovary occasionally (8%) have subclinical PCOS but often (42%) have a subclinical PCOS type of ovarian dysfunction, the prognosis for which is unclear.

Conclusion: Identifying children at risk for PCOS offers the prospect of eventually preventing some of the long-term complications associated with this syndrome once our understanding of the basis of the disorder improves.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Adrenarche / physiology
  • Anovulation / etiology
  • Child
  • Female
  • Humans
  • Hypothalamus / physiopathology
  • Models, Biological
  • Obesity / etiology
  • Ovary / physiopathology
  • Pituitary Gland / physiopathology
  • Polycystic Ovary Syndrome / congenital
  • Polycystic Ovary Syndrome / diagnosis*
  • Polycystic Ovary Syndrome / etiology
  • Polycystic Ovary Syndrome / physiopathology
  • Puberty, Precocious / etiology
  • Risk Factors