Maternal polycystic ovary syndrome and the risk of neurodevelopmental disorders in preterm neonates.

INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with increased obstetric complications. However, its impact on the neurodevelopment of preterm neonates remains underexplored, particularly in low-resource settings. The study aimed to assess the association between maternal PCOS and the risk of neurodevelopmental disorders in preterm neonates. MATERIAL AND METHODS: A prospective case-control study was conducted at Azadi Teaching Hospital, Kirkuk, Iraq, from June 2023 to June 2025. A total of 200 women with preterm labor were enrolled and divided into two groups - Group A (PCOS, n = 100) and Group B (non-PCOS, n = 100) - based on the Rotterdam criteria. Neonatal outcomes - including gestational age, birth weight, Apgar scores, neonatal intensive care unit (NICU) stay, intraventricular hemorrhage (IVH), periventricular leukomalacia, seizures, and neurodevelopment - were assessed. Neurodevelopmental evaluation was performed at 6, 12, and 24 months using the Denver II screening test. Logistic regression was used to identify predictors of developmental delay. RESULTS: Neonates born to mothers with PCOS had significantly lower birth weights, longer NICU stays, higher rates of IVH and seizures, and lower Apgar scores. Developmental delays - particularly in fine motor, language, and gross motor domains - were significantly more prevalent in the PCOS group (p < 0.001). Logistic regression identified maternal PCOS, NICU stay, Homeostatic Model Assessment for Insulin Resistance, IVH, and 1-minute Apgar score as independent predictors of neurodevelopmental delay. CONCLUSIONS: Maternal PCOS is associated with an increased risk of neurodevelopmental disorders in preterm neonates. Targeted screening and follow-up are necessary for women at high risk.