Aim: Anogenital distance (AGD) is a biomarker for the prenatal hormonal environment. Scarce evidence exists regarding the effect of prenatal androgen exposure in mothers with polycystic ovary syndrome (PCOS) on the human fetal AGD. The aim of the study was to assess the prenatal sonographic measurement of AGD in fetuses of PCO mothers vs the general population.
Materials and methods: AGD was measured prospectively infetuses at 26–37 weeks of gestation, using 2D ultrasound, in an axial view, at the level of the fetal perineum. Data was compared to fetal AGD nomograms, and the Z score was evaluated. Maternal and fetal characteristics were analyzed.
Results: 27 PCOS mothers carrying singleton fetuses were recruited (12 females, 15 males). Mean gestational age at measurement was 31.2 weeks ± 3 days. Mean AGD, adjusted for gestational age and gender, was significantly higher in the PCOS (21.13 mm ± 5.9 mm) compared to the control (17.19 mm ± 5.45 mm) group, respectively, P < 0.001. Mean AGD-PCOS centile was 86.04 (±18.22). Z score was not statistically different in the males (2.035 ± 2.1950) compared to the females (2.185 ± 1.3834). The AGD measured in fetuses of mothers with diabetes (52% of the study group) was significantly longer compared to the general population (19.74 mm ± 4.8 mm vs 15.11 mm ± 4.77 mm P < 0.001).
Conclusions: This is the first report demonstrating a longer AGD in fetuses of mothers with PCOS. AGD may play a role as a biomarker of the intra-uterine androgen milieu, specifically in PCOS. Importantly, this might change the way we approach and treat PCOS pregnancies.
05 Sep 2020 - 09 Sep 2020