Introduction:

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Increasing evidence suggests that this syndrome, in addition to affecting maternal reproductive health, may be associated with adverse neurodevelopmental outcomes in offspring. Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with a rising prevalence, and the role of maternal factors during preconception and pregnancy periods in its development has received growing attention. Accordingly, the present study aimed to systematically review the existing evidence on the association between maternal PCOS and the risk of ASD in offspring.

Methods:

This study was conducted as a systematic review following the PRISMA guidelines. Searches were performed in the PubMed, Scopus, Web of Science, Google Scholar databases, as well as the Persian databases SID and Magiran, without language restrictions, covering the period from 2000 to July 2024. Study quality was assessed using the Newcastle–Ottawa Scale.

Results:

Out of a total of 1,240 articles identified, after removing duplicates and applying the inclusion and exclusion criteria, nine studies of moderate to high quality were included in the systematic review. Most studies reported that maternal PCOS was associated with an increased risk of ASD in offspring.

Conclusion:

Based on the available evidence, maternal PCOS appears to be associated with an increased risk of autism spectrum disorder in offspring, although heterogeneity in results and the potential influence of confounding factors limit causal interpretation. Longitudinal and mechanism-focused studies are warranted to elucidate the biological pathways underlying this association