Table 3 Joint effect of maternal polycystic ovary syndrome and other comorbidities before childbirth on the risk of cardiovascular disease in offspring

From: Maternal polycystic ovary syndrome and Offspring’s Risk of Cardiovascular diseases in Childhood and Young Adulthood

Exposure

Number of events

Event rate, per 10000 person-years

HR (95% CI)

Model 1a

Model 2b

Model 3c

Model 4d

Maternal PCOS and diabetes

No PCOS, no diabetes

378 834

23.92

1.0 (Reference)

1.0 (Reference)

1.0 (Reference)

1.0 (Reference)

Only PCOS

1 399

22.04

1.55 (1.48–1.64)

1.21 (1.15–1.28)

1.51 (1.44–1.59)

1.20 (1.14–1.26)

Only diabetes

3 948

24.72

1.41 (1.37–1.46)

1.23 (1.19–1.27)

1.37 (1.33–1.42)

1.21 (1.18–1.25)

Both PCOS and diabetes

93

29.79

2.63 (2.15–3.22)

1.75 (1.43–2.14)

2.43 (1.99–2.98)

1.68 (1.37–2.06)

Synergy index and 95% CI for the additive interaction between PCOS and diabetes

1.80 (1.75–1.85)

Maternal PCOS and hypertensive disease

No PCOS, no hypertensive disease

371 377

23.89

1.0 (Reference)

1.0 (Reference)

1.0 (Reference)

1.0 (Reference)

Only PCOS

1 369

22.16

1.58 (1.49–1.67)

1.22 (1.16–1.29)

1.54 (1.46–1.63)

1.21 (1.15–1.28)

Only hypertensive disease

11 405

25.12

1.33 (1.30–1.35)

1.22 (1.19–1.24)

1.31 (1.29–1.34)

1.21 (1.19–1.23)

Both PCOS and hypertensive disease

123

25.49

1.90 (1.59–2.27)

1.44 (1.20–1.71)

1.81 (1.51–2.16)

1.40 (1.17–1.67)

Synergy index and 95% CI for the additive interaction between PCOS and hypertensive disease

1.89 (1.75–2.04)

Maternal PCOS and overweight/obesitye

No PCOS, no overweight/obesity

77 063

20.30

1.0 (Reference)

1.0 (Reference)

1.0 (Reference)

1.0 (Reference)

Only PCOS

367

20.25

1.36 (1.23–1.51)

1.16 (1.05–1.29)

1.34 (1.21–1.48)

1.15 (1.04–1.27)

Only overweight/obesity

32 212

19.37

1.09 (1.08–1.11)

1.02 (1.01–1.04)

1.08 (1.06–1.09)

1.01 (1.00–1.03)

Both PCOS and overweight/obesity

530

21.14

1.48 (1.37–1.62)

1.24 (1.14–1.35)

1.42 (1.30–1.55)

1.20 (1.10–1.30)

Synergy index and 95% CI for the additive interaction between PCOS and overweight/obesity

2.23 (1.81–2.75)

Maternal PCOS and psychiatric disorders

No PCOS, no psychiatric disorders

372 232

23.93

1.0 (Reference)

1.0 (Reference)

1.0 (Reference)

1.0 (Reference)

Only PCOS

1 340

22.06

1.55 (1.47–1.64)

1.22 (1.15–1.28)

1.52 (1.44–1.60)

1.20 (1.14–1.27)

Only psychiatric disorders

10 551

23.92

1.41 (1.38–1.44)

1.19 (1.17–1.22)

1.40 (1.37–1.43)

1.19 (1.17–1.21)

Both PCOS and psychiatric disorders

152

25.98

2.32 (1.98–2.72)

1.55 (1.32–1.81)

2.24 (1.91–2.63)

1.52 (1.29–1.78)

Synergy index and 95% CI for the additive interaction between PCOS and psychiatric disorders

1.77 (1.69–1.86)

  1. Abbreviations: PCOS polycystic ovary syndrome, HR hazard ratio, CI confidence interval.
  2. aModel 1 was unadjusted.
  3. bModel 2 was adjusted for sex, country and calendar year of birth, as well as maternal country of origin, parity, age, education, and marital status at the time of birth.
  4. cModel 3 was adjusted for maternal hypertensive disease (except when examining its joint effect with polycystic ovary syndrome), diabetes (except when examining its joint effect with polycystic ovary syndrome), and psychiatric disorders (except when examining their joint effect with polycystic ovary syndrome) before or during the index pregnancy.
  5. dModel 4 was adjusted for sex, country and calendar year of birth, as well as maternal country of origin, parity, age, education, and marital status at the time of birth, hypertensive disease (except when examining its joint effect with polycystic ovary syndrome), diabetes (except when examining its joint effect with polycystic ovary syndrome) and psychiatric disorders (except when examining their joint effect with polycystic ovary syndrome) before or during the index pregnancy, and family history of cardiovascular disease.
  6. eThis analysis was performed for individuals with data on maternal body-mass index available in early pregnancy (N = 3 274 570).
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