Neuropsychiatric disorders in children of mothers with polycystic ovary syndrome: a systematic review and meta-analysis.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age, yet its association with neuropsychiatric disorders (NPDs) in offspring remains inconsistent and requires updated synthesis. METHODS: We systematically searched PubMed, Embase, Web of Science, and Cochrane Library up to March 2025. A total of 21 observational studies involving 6.8 million mothers and 7.4 million offspring were included. Quality assessment was performed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted to estimate pooled odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Maternal PCOS was significantly associated with increased risks of autism spectrum disorder (OR = 1.44, 95% CI: 1.36–1.53), attention-deficit/hyperactivity disorder (OR = 1.42, 95% CI: 1.35–1.49), chronic tic disorders (OR = 1.45, 95% CI: 1.24–1.68), anxiety (OR = 1.34, 95% CI: 1.27–1.42), other behavioral/emotional disorders (OR = 1.35, 95% CI: 1.30–1.39), and neurological malformations (OR = 1.47, 95% CI: 1.12–1.94). Subgroup analyses by offspring sex and diagnostic criteria showed consistent effects, though sex differences were not significant. Sensitivity analyses confirmed result stability. CONCLUSION: This study provides evidence of an association between maternal PCOS and elevated odds of NPDs in children, highlighting the potential importance of prenatal metabolic health and developmental surveillance in this population. CLINICAL TRIAL NUMBER: Not applicable.