TOPLINE

Exposure to adverse childhood experiences was associated with a higher lifetime prevalence of self-reported polyendocrine metabolic ovarian syndrome (PMOS) among pregnancy planners. Those who reported four or more adverse childhood experiences had a more than 60% higher prevalence of PMOS than those who reported none.

METHODOLOGY

• Researchers conducted a cross-sectional analysis of data from a preconception cohort study (PRESTO), including 10,856 women aged 21-45 years enrolled from the US and Canada during 2013-2025, to assess the link between adverse childhood experiences and the prevalence of PMOS, formerly known as polycystic ovary syndrome.
• Participants who were not pregnant at enrollment completed a baseline questionnaire and shared information on their sociodemographics, behavioral factors, and medical history, with follow-up every 2 months for up to a year or until pregnancy.
• They completed a supplemental questionnaire 30 days after enrollment; the questionnaire included a module on adverse childhood experiences that assessed exposure to household mental illness, substance abuse, and incarceration; parental separation or divorce and interpersonal violence; and physical, emotional, and sexual abuse before the age of 18 years.
• Self-reported physician-diagnosed PMOS was ascertained from baseline and follow-up questionnaires during preconception and was also assessed on the basis of characteristics such as long intervals between periods or very few periods each year.

TAKEAWAY

• Overall, 10.8% of women reported a lifetime diagnosis of PMOS, with 52% of cases diagnosed before the age of 25 years. The prevalence of self-reported PMOS ranged from 7.4% in those with no adverse childhood experience to 14.2% in those with four or more adverse childhood experiences.
• Exposure to one to three and four or more vs no adverse childhood experiences was associated with an increased prevalence of PMOS (weighted and fully adjusted prevalence ratio [aPR], aPR, 1.64; 95% CI, 1.33-2.01 and 1.33; 95% CI, 1.11-1.60, respectively).
• Each 1-unit increase in the adverse childhood experience score was associated with an aPR of 1.08 (95% CI, 1.05-1.11).
• Sexual abuse was associated with the largest increase in the prevalence of PMOS (aPR, 1.82; 95% CI, 1.45-2.29), followed by parental interpersonal violence (aPR, 1.68; 95% CI, 1.29-2.17), emotional abuse (aPR, 1.54; 95% CI, 1.28-1.86), physical abuse (aPR, 1.52; 95% CI, 1.21-1.90), household mental illness (aPR, 1.46; 95% CI, 1.21-1.77), and parental separation or divorce (aPR, 1.43; 95% CI, 1.15-1.77).

IN PRACTICE

“[The study] findings build upon a growing evidence base linking early stress to later gynecologic health and highlight the importance of efforts aimed at reducing early life adversities,” the authors of the study wrote.

SOURCE

The study was led by Lauren A. Wise, ScD, Department of Epidemiology, Boston University School of Public Health, Boston. It was published online on June 24, 2026, in the American Journal of Obstetrics & Gynecology.

LIMITATIONS

The analysis was cross-sectional in nature; hence, recall bias cannot be ruled out. In a subset of participants, PMOS may have preceded early-life adverse experiences. The study relied on self-reported PMOS data, and given that diagnostic criteria for PMOS have changed over the years, misclassification of PMOS may be possible.

DISCLOSURES

The study received support from the National Institutes of Health. One author disclosed receiving in-kind donations from chartneo.com for fertility tracking apps used in Pregnancy Study Online (PRESTO).

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.