The neurodevelopment of neonates born to women with polycystic ovary syndrome: evidences from China

The neurodevelopment of neonates born to women with polycystic ovary syndrome: evidences from China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The neurodevelopment of neonates born to women with polycystic ovary syndrome: evidences from China Dan Shen, Min-Chen Dai, Yue Jin, Zhou Jiang, Tian-Yi Zhou, Fan Qu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2933379/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Mothers with PCOS are at increased risk of various gestational complications and adverse outcomes of offspring. The health problems, including neurobehavioral phenotypes, of PCOS offspring has attracted wide attention and been associated with intrauterine environment changes due to maternal PCOS. Using neonatal behavioral neurological assessment (NBNA), we conducted measurement of neonate’s neurodevelopment on the third day after birth. Total score of NBNA and score of behavioral capacity, orientation response-animate visual and auditory, were significantly lower in PCOS group than those in control group. Concerning sex difference, we found significantly lower total score of NBNA and score of behavioral capacity, orientation response-inanimate visual, in male neonates of PCOS group compared to those of control group, while this did not exist in female neonates. In conclusion, our data indicated an association between maternal PCOS and offspring neurobehavior at the beginning of neonatal period in a sex-specific manner. Further evidence of intrauterine environment is required to clarify the potential mechanism underlying impacts of maternal PCOS on neurodevelopment. Polycystic ovary syndrome (PCOS) offspring neurodevelopment What is known Mothers with PCOS are at increased risk of gestational diabetes, hypertension, endothelial dysfunction and pre-eclampsia, which can alter the fetal endocrine environment, leading to adverse outcomes in offspring. The babies born to PCOS mothers had a significantly higher risk of admission to a neonatal intensive care unit and a higher perinatal mortality, unrelated to multiple births. A significantly higher prevalence of obesity, diabetes, cardiovascular disease was observed in offspring of women with PCOS, which could not be completely attributed to pregnancy complications, and seems to be more related to maternal PCOS condition, which our studies also lend support to. Concerning neurobehavioral phenotypes, maternal PCOS has been reported to respectively increase the odds of offspring attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) by 42% and 59%. Consistently, the previous work of the author’s group has suggested a different pattern of brain metrics in PCOS offspring in utero, and alterations of neurobehavioral phenotypes in female offspring of both women with PCOS and PCOS model rats which might involve learning and memory. What is new: Neonatal behavioral neurological assessment (NBNA) was used as the measurement of neonates neurodevelopment in the current study, which was administered on the third day after birth. NBNA was invented by Bao et al based on the method of Brazelton and Amiel-Tison for behavioral neurological measurement in neonates as well as the clinical experiences in Chinese new-borns. The NBNA was tested with distinct stability and reliability by several large cohorts in China, and showed high consistency over various geographic locations . In the current study, total score of NBNA and score of behavioral capacity, orientation response-animate visual and auditory, were significantly lower in PCOS group than those in control group. Moreover, male neonates in PCOS group showed significantly lower total score of NBNA and score of behavioral capacity, especially orientation response-inanimate visual, than those in controls, while the female PCOS neonates did not. This result indicated that PCOS offspring probably showed social attention impairments, and that the male neonates of women with PCOS might have lower visual sensory ability of nonsocial information, which appeared as early as the beginning of the neonatal period. The possible explanation for sex difference in neurobehavior of PCOS offspring is that intrauterine androgen exposure in male PCOS offspring is most enhanced resulting from both maternal PCOS condition and fetal testicular function. INTRODUCTION Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Women with PCOS exhibit heterogeneous features which involve reproductive, metabolic and psychological function [1, 2]. The specific gene mutations affecting androgen synthesis, insulin secretion and insulin activity explain most of the endocrine and metabolic symptoms, while environmental risk factors (during either prenatal or postnatal life), seem to convert an occult PCOS into a clinically manifest syndrome[3]. Mothers with PCOS are at increased risk of gestational diabetes, hypertension, endothelial dysfunction and pre-eclampsia, which can alter the fetal endocrine environment, leading to adverse outcomes in offspring[4]. The babies born to PCOS mothers had a significantly higher risk of admission to a neonatal intensive care unit and a higher perinatal mortality, unrelated to multiple births[5]. A significantly higher prevalence of obesity, diabetes, cardiovascular disease was observed in offspring of women with PCOS, which could not be completely attributed to pregnancy complications, and seems to be more related to maternal PCOS condition[6-9], which our studies also lend support to[10-12]. Concerning neurobehavioral phenotypes, maternal PCOS has been reported to respectively increase the odds of offspring attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) by 42% and 59%[13-16]. Consistently, the previous work of the author’s group has suggested a different pattern of brain metrics in PCOS offspring in utero[17], and alterations of neurobehavioral phenotypes in female offspring of both women with PCOS[18] and PCOS model rats[19] which might involve learning and memory. Hence, further study is needed to confirm the role of maternal PCOS in early offspring neurodevelopment for both boys and girls. METHODS The recruitment of pairs of mother and neonate and collection of clinical information This study was conducted between December 2016 and June 2017 in two hospitals in China, including Hangzhou Red Cross Hospital and Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University. Nineteen neonates born to mothers with PCOS and 38 neonates (as controls) born to the healthy mothers were recruited. Written informed consent was obtained from all the women. The study was approved by the Ethics Committee of Hangzhou Red Cross Hospital, Hangzhou, China. All mothers with PCOS were diagnosed according to the Rotterdam Consensus (European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine criteria)[20]. During recruitment, the mother’s age, body weight, height, pregnancy complication, parity, educational background and conception mode were noted. Birth mode, gestational week, gender, birth weight, serum bilirubin and Apagar score of neonates were recorded after birth. Assessment of growth and neurodevelopment status of neonates Neonatal behavioral neurological assessment (NBNA) was used as the measurement of neonates neurodevelopment in the current study, which was administered on the third day after birth. NBNA was invented by Bao et al[21] based on the method of Brazelton and Amiel-Tison for behavioral neurological measurement in neonates as well as the clinical experiences in Chinese new-borns. The NBNA was tested with distinct stability and reliability by several large cohorts in China, and showed high consistency over various geographic locations [22, 23]. The NBNA assesses functional abilities, most reflexes and responses, and stability of behavioural status during the examination. It involves five scales: behavior (six items), passive tone (four items), active tone (four items), primary reflexes (three items), and general assessment (three items). Each above item has three dimensions of score (0, 1 and 2). Twenty items are summarized in the summary score with a maximum score of 40. Neonates with summary score more than 37 were considered to be well developed, and those with summary score more than 35 and lower than 37 were considered to be acceptable, otherwise neonates would probably be associated with poor clinical outcomes. Examiners were blinded with regard to exposure status when NBNA were carried out. Statistical analysis All data were analyzed with SPSS Version 21.0. Independent sample t-test was used to compare variables approximately normally distributed, and a nonparametric test (Mann-Whitney U test) was used for variables with distributions other than normal. Numeration data were analyzed using chi-square test and Fisher’s exact test when the cell count was <5. P<0.05 was considered statistically significant. RESULTS Baseline clinical characteristics Concerning the mothers: age, BMI, duration of pregnancy, pregnancy complication, educational background and mode of delivery did not differ between two groups (all P>0.05, Table 1). However, mode of conception and parity differed significantly between two groups (P=0.010 and P=0.003, respectively, Table 1). Concerning the offspring: gender, birth weight, and Apgar score were comparable between two groups (all P>0.05, Table 1). After divided into subgroups based on neonatal gender, we observed comparable baseline clinical characteristics of both mothers and neonates (all P>0.05, Table 2) except mothers’ parity in subgroup of male offspring and mode of conception in subgroup of female offspring (P=0.010 and P=0.023, respectively, Table 2). Table 1 Baseline clinical characteristics of pairs of mothers and neonates Characteristics PCOS(n=19) Control(n=38) P value Mother Age(years) 31.16±4.03 31.73±4.10 0.621 BMI(kg/m 2 ) 26.42±3.54 27.36±2.75 0.291 Mode of conception Natural 15(78.95) 38(100.00) 0.010 * Ovulation induction 2(10.53) 0 IVF/ICSI 2(10.53) 0 Gestational week 39.65±1.15 39.33±0.94 0.274 Pregnancy complication Gestational diabetes mellitus 2(10.50) 6(15.80) 0.590 Thyroid dysfunction 4(21.10) 4(10.50) 0.500 Group B streptococcal infection 2(10.50) 1(2.60) 0.529 Parity 1.22±0.55 1.70±0.52 0.003 # Educational background ** University 11(57.90) 10(27.00) 0.063 High school 6(31.60) 15(40.50) Less than high school 2(10.50) 12(32.40) Mode of delivery Vaginal delivery 10(52.60) 26(68.40) 0.244 Cesarean section delivery 9(47.40) 12(31.60) Offspring Neonatal gender Male 10(52.60) 18(47.40) 0.708 Female 9(47.40) 20(52.60) Birth weight(g) 3392.11±424.02 3426.32±321.26 0.735 Apgar score 10.00±0.00 10.00±0.00 - Note: Data were presented as mean±SD or number (percentage). * P<0.05, compared with control group; # P<0.01, compared with control group. ** Missing data for one subject. Table 2 Baseline clinical characteristics of pairs of mothers and neonates in subgroups based on neonatal gender Characteristics Male offspring(n=28) Female offspring(n=29) PCOS(n=10) Control(n=18) P value PCOS(n=9) Control(n=20) P value Mother Age(years) 30.60±4.09 30.67±3.97 0.967 31.78±4.12 32.74±4.07 0.567 BMI(kg/m 2 ) 26.85±3.25 27.95±2.46 0.332 25.94±4.01 26.81±2.96 0.538 Mode of conception Natural 9(90.00) 18(100.00) 0.357 6(66.67) 20(100.00) 0.023 * Ovulation induction 0 0 2(22.22) 0 IVF/ICSI 1(10.00) 0 1(11.11) 0 Gestational week 39.60±1.40 39.60±0.67 0.988 39.70±0.86 39.09±1.09 0.150 Pregnancy complication Gestational diabetes mellitus 0 4(22.22) 0.265 2(22.22) 2(10.00) 0.568 Thyroid dysfunction 3(30.00) 1(5.56) 0.116 1(11.11) 3(15.00) 1.000 Group B streptococcal infection 1(10.00) 1(5.56) 1.000 1(11.11) 0 0.310 Parity 1.20±0.42 1.71±0.47 0.010 * 1.25±0.71 1.70±0.57 0.090 Educational background ** University 4(40.00) 3(16.67) 0.280 7(77.78) 7(36.84) 0.176 High school 5(50.00) 9(50.00) 1(11.11) 6(31.58) Less than high school 1(10.00) 6(33.33) 1(11.11) 6(31.58) Mode of delivery Vaginal delivery 4(40.00) 8(44.44) 1.000 6(66.67) 18(90.00) 0.287 Cesarean section delivery 6(60.00) 10(55.56) 3(33.33) 2(10.00) Offspring Birth weight(g) 3565.00±323.22 3541.67±338.79 0.861 3200.00±456.21 3322.50±272.65 0.374 Apgar score 10.00±0.00 10.00±0.00 - 10.00±0.00 10.00±0.00 - Note: Data were presented as mean±SD or number (percentage). * P<0.05, compared with control group. ** Missing data for one subject. Neonatal neurodevelopment Total score of NBNA and score of behavioral capacity (especially in orientation response-animate visual and auditory) were significantly lower in PCOS group than those in control group (all P0.05, Table 3). To investigate the gender difference, we compared neonatal neurodevelopment between girls and boys in both PCOS and control groups. On one hand, male neonates in PCOS group showed significantly lower total score of NBNA and score of behavioral capacity, especially orientation response-inanimate visual, than those in control group (all P<0.05), but there was no statistical difference between two groups in active muscle tension, passive muscle tension, primitive reflex and general status. On the other hand, female neonates were comparable in all items of NBNA score between PCOS and control groups (all P>0.05, Table 4). In addition, we found no statistical differences in all items of NBNA scores between female neonates and male neonates in both PCOS and control groups (all P>0.05, Table 4). Table 3 Comparison of NBNA between PCOS group and control group Item PCOS(n=19) Control(n=38) P value Total NBNA 36.68±1.11 37.76±1.08 0.001 # BC 8.84±1.12 9.92±1.08 0.001 # AMT 7.95±0.23 7.97±0.16 0.618 PMT 8.00±0.00 7.95±0.23 0.317 PR 5.89±0.32 5.92±0.27 0.746 GS 6.00±0.00 6.00±0.00 - Response decrement to light 2.00±0.00 2.00±0.00 - Response decrement to rattle 1.84±0.37 1.97±0.16 0.158 Orientation response-inanimate auditory 1.26±0.45 1.53±0.51 0.054 Orientation response-inanimate visual 1.05±0.52 1.21±0.41 0.220 Orientation response-animate visual and auditory 0.89±0.66 1.24±0.43 0.022 * Consolability 1.79±0.42 1.97±0.16 0.079 Scarf sigh 2.00±0.00 2.00±0.00 - Recoil of upper limbs 2.00±0.00 2.00±0.00 - Recoil of lower limbs 2.00±0.00 2.00±0.00 - Popliteal angle 1.95±0.23 1.97±0.16 0.618 Raise to sit 2.00±0.00 2.00±0.00 - Hand grasp 2.00±0.00 1.95±0.23 0.160 Pull reaction 2.00±0.00 2.00±0.00 - Righting reaction 2.00±0.00 2.00±0.00 - Automatic walking 1.89±0.32 1.92±0.27 0.746 Moro reflex 2.00±0.00 2.00±0.00 - Sucking 2.00±0.00 2.00±0.00 - Alertness 2.00±0.00 2.00±0.00 - Crying 2.00±0.00 2.00±0.00 - Activity level 2.00±0.00 2.00±0.00 - Note: Data were presented as mean±SD. * P<0.05, compared with control group; # P<0.01, compared with control group. AMT=active muscle tension, BC=behavioral capacity, GS=general status, NBNA=neonatal behavioral neurological assessment, PMT=passive muscle tension, PR=primitive reflex. Table 4 Comparison of NBNA between PCOS group and control group based on neonatal gender Item PCOS(n=19) Control(n=38) P value Female (n=9) Male (n=10) Female (n=20) Male (n=18) PF vs. CF PM vs. CM PF vs. PM CF vs. CM Total NBNA 36.67±1.50 36.70±0.67 37.65±1.04 37.89±1.13 0.050 0.006 # 0.950 0.502 BC 9.00±1.50 8.70±0.67 9.80±1.11 10.06±1.06 0.118 0.001 # 0.574 0.472 AMT 7.89±0.33 8.00±0.00 8.00±0.00 7.94±0.24 0.347 0.466 0.347 0.331 PMT 8.00±0.00 8.00±0.00 7.95±0.22 7.94±0.24 0.512 0.466 - 0.941 PR 5.78±0.44 6.00±0.00 5.90±0.31 5.94±0.24 0.395 0.466 0.169 0.623 GS 6.00±0.00 6.00±0.00 6.00±0.00 6.00±0.00 - - - - Response decrement to light 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Response decrement to rattle 1.89±0.33 1.80±0.42 2.00±0.00 1.94±0.24 0.347 0.337 0.620 0.331 Orientation response-inanimate auditory 1.33±0.50 1.20±0.42 1.50±0.51 1.56±0.51 0.422 0.061 0.537 0.740 Orientation response-inanimate visual 1.22±0.67 0.90±0.32 1.20±0.41 1.22±0.43 0.913 0.048 * 0.213 0.871 Orientation response-animate visual and auditory 0.78±0.67 1.00±0.67 1.15±0.37 1.33±0.49 0.146 0.140 0.478 0.202 Consolability 1.78±0.44 1.80±0.42 1.95±0.22 2.00±0.00 0.294 0.168 0.912 0.350 Scarf sigh 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Recoil of upper limbs 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Recoil of lower limbs 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Popliteal angle 1.89±0.33 2.00±0.00 2.00±0.00 1.94±0.24 0.347 0.466 0.347 0.331 Raise to sit 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Hand grasp 2.00±0.00 2.00±0.00 1.95±0.22 1.94±0.24 0.512 0.466 - 0.941 Pull reaction 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Righting reaction 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Automatic walking 1.78±0.44 2.00±0.00 1.90±0.31 1.94±0.24 0.395 0.466 0.169 0.623 Moro reflex 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Sucking 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Alertness 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Crying 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Activity level 2.00±0.00 2.00±0.00 2.00±0.00 2.00±0.00 - - - - Note: Data were presented as mean±SD. PF=PCOS female group, PM=PCOS male group, CF=control female group, CM=control male group, AMT=active muscle tension, BC=behavioral capacity, GS=general status, NBNA=neonatal behavioral neurological assessment, PMT=passive muscle tension, PR=primitive reflex. * P<0.05, significant difference; # P<0.01, significant difference. Discussion Little is known about the effects of maternal PCOS on fetal development[23]. During pregnancy, PCOS women have been shown to have increased blood androgen concentrations compared to control women[24]. This increase could affect the intrauterine androgen exposure of offspring. Female infants born to women with PCOS were found to have umbilical testosterone concentrations not only higher than control females but comparable to control males[25]. A positive association was found between elevated fetal testosterone in amniotic fluid and autistic features[26]. Elevated fetal testosterone in the mixture of arterial and venous umbilical cord blood also showed a high risk of language delay, particularly in male children[27]. Recent studies support the hypothesis that prenatal exposure to testosterone contributes to cognitive function development[28]. This would suggest that maternal PCOS with excess androgens, would increase the risk of ASD in the offspring[29]. ASD is a set of heterogenous neurodevelopment conditions characterised by deficits in social communication, as well as severe anxiety and repetitive, restricted behaviour and interests[30-32], with worldwide prevalence of 1% to 2%[33-37]. The aetiology of autism is not fully understood, but genetics and early environmental factors can be the main causes of affecting the neurodevelopment[38-41]. Possible risk factors include advanced parental age[42, 43], exposure to chemicals[40, 44-47] and hormones[48-50] during pregnancy and perinatal and neonatal complications[39]. High prenatal fetal testosterone levels could affect the development of sexually dimorphic brain structures, thus lead to sex differences and autistic traits in individuals[51]. This idea is supported by the ‘extreme male brain of autism’ theory[52] that extend the ‘empathising-systemising theory’ in typical sex differences[53]. These theories argue that individuals with ASD have male-typical ‘systemising’ cognitive abilities, considered as the drive to analyse and construct a system and less female-typical ‘empathising’ profiles[52, 53]. Nevertheless, they were challenged by controversial evidence. Kung et al . showed no evidence in their study testing autistic traits in children with congenital adrenal hyperplasia and typically developing children with amniotic fluid[54]. Considerable research has found that children with autism orient less frequently to both social and nonsocial stimuli than their peers[55]. ASD children showed distinct visual working memory and sensory processing[56]. In the current study, total score of NBNA and score of behavioral capacity, orientation response-animate visual and auditory, were significantly lower in PCOS group than those in control group. Moreover, male neonates in PCOS group showed significantly lower total score of NBNA and score of behavioral capacity, especially orientation response-inanimate visual, than those in controls, while the female PCOS neonates did not. This result indicated that PCOS offspring probably showed social attention impairments, and that the male neonates of women with PCOS might have lower visual sensory ability of nonsocial information, which appeared as early as the beginning of the neonatal period. The possible explanation for sex difference in neurobehavior of PCOS offspring is that intrauterine androgen exposure in male PCOS offspring is most enhanced resulting from both maternal PCOS condition and fetal testicular function. Limitations in the present study point to the direction of our future work. Firstly, increasing sample size is crucial to provide statistical power. This can be achieved by recruiting both more PCOS mothers and controls with an equal ratio of sons and daughters. Secondly, intrauterine androgen exposure of PCOS offspring should be further clarified. Currently, there is no established method that is both ethical and practical that can measure prenatal hormone exposure[57]. An ideal method could be through fetal blood collected during the critical period of neurodevelopment, but this is not feasible because of ethical reasons. Amniotic fluid is an alternative approach which probably reflects testosterone in fetal blood, but the sampling procedure (amniocentesis) is only performed for prenatal diagnosis for high-risk pregnancies[58]. In addition, intrauterine exposure of other endocrine factors besides androgen are also promising to give interpretation for the altered neurodevelopment of PCOS offspring[59]. To sum up, the current study suggested an association between maternal PCOS and offspring neurobehavior at the beginning of neonatal period in a sex-specific manner. Our findings provide a clue for the mechanism underlying that prenatal androgen exposure impacts the neurodevelopment of offspring. However, our study is too small to answer whether early attention or intervention is required for children of PCOS mothers. It should be noted that children of PCOS mothers showed neurobehavior changes might related to autistic traits, but the risk of having children with ASD for PCOS women is still rare[13, 60, 61]. Therefore, the association between two conditions should not be overstated to avoid unnecessary stress on mothers with PCOS. Further research is required to understand the mechanisms of PCOS and ASD, as well as the involvement in fetal, maternal hormone levels and other conditions to optimise clinical interventions. abbreviations Abbreviations Full Name ADHD attention-deficit/hyperactivity disorder AMT active muscle tension ASD autism spectrum disorders BC behavioral capacity CF control female group CM control male group GS general status NBNA neonatal behavioral neurological assessment PCOS polycystic ovarian syndrome PF PCOS female group PM PCOS male group PMT passive muscle tension PR primitive reflex Declarations Funding: This study was supported by the Zhejiang Province Science Foundation for Key Program [LZ21H270001 to F.Q.], the National Natural Science Foundation of China [grant nos. 81874480 and 82074476 to F.Q.], and Zhejiang Traditional Chinese Medicine Foundation [No.2021ZQ051 to Y.J.]. C ompeting I nterests : The authors have no relevant financial or non-financial interests to disclose. Author C ontribution s: Conceptualization: Fan Qu, Fang-Fang Wang; Methodology: Fan Qu, Fang-Fang Wang; Formal analysis and investigation: Dan Shen,Min-Chen Dai; Writing - original draft preparation: Tian-Yi Zhou,Yue Jin; Writing- review and editing: Fan Qu, Fang-Fang Wang; Resources: Dan Shen, Zhou Jiang; Supervision: Fan Qu, Fang-Fang Wang. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hangzhou Red Cross Hospital, Hangzhou, China.(Date 2016.12.16/No [2016] 07) Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent to publish: Patients signed informed consent regarding publishing their data. Acknowledgements ： Not applicable. References Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet 2007;370(9588):685-97.https://doi.org/10.1016/s0140-6736(07)61345-2 Rosenfield RL, Ehrmann DA. 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J Autism Dev Disord 2013;43(11):2526-35.https://doi.org/10.1007/s10803-013-1801-3 Volk HE, Lurmann F, Penfold B, Hertz-Picciotto I, McConnell R. Traffic-related air pollution, particulate matter, and autism. JAMA Psychiatry 2013;70(1):71-7.https://doi.org/10.1001/jamapsychiatry.2013.266 Roberts EM, English PB, Grether JK, Windham GC, Somberg L, Wolff C. Maternal residence near agricultural pesticide applications and autism spectrum disorders among children in the California Central Valley. Environ Health Perspect 2007;115(10):1482-9.https://doi.org/10.1289/ehp.10168 Christensen J, Grønborg TK, Sørensen MJ, Schendel D, Parner ET, Pedersen LH, et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. Jama 2013;309(16):1696-703.https://doi.org/10.1001/jama.2013.2270 Rai D, Lee BK, Dalman C, Golding J, Lewis G, Magnusson C. Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. Bmj 2013;346:f2059.https://doi.org/10.1136/bmj.f2059 Auyeung B, Baron-Cohen S, Ashwin E, Knickmeyer R, Taylor K, Hackett G. Fetal testosterone and autistic traits. Br J Psychol 2009;100(Pt 1):1-22.https://doi.org/10.1348/000712608x311731 de Cock M, Maas YG, van de Bor M. Does perinatal exposure to endocrine disruptors induce autism spectrum and attention deficit hyperactivity disorders? Review. Acta Paediatr 2012;101(8):811-8.https://doi.org/10.1111/j.1651-2227.2012.02693.x Baron-Cohen S, Auyeung B, Nørgaard-Pedersen B, Hougaard DM, Abdallah MW, Melgaard L, et al. Elevated fetal steroidogenic activity in autism. Molecular psychiatry 2015;20(3):369-76.https://doi.org/10.1038/mp.2014.48 Baron-Cohen S, Lombardo MV, Auyeung B, Ashwin E, Chakrabarti B, Knickmeyer R. Why are autism spectrum conditions more prevalent in males? PLoS Biol 2011;9(6):e1001081.https://doi.org/10.1371/journal.pbio.1001081 Baron-Cohen S. The extreme male brain theory of autism. Trends Cogn Sci 2002;6(6):248-54.https://doi.org/10.1016/s1364-6613(02)01904-6 Baron-Cohen S. Empathizing, systemizing, and the extreme male brain theory of autism. Prog Brain Res 2010;186:167-75.https://doi.org/10.1016/b978-0-444-53630-3.00011-7 Kung KT, Spencer D, Pasterski V, Neufeld S, Glover V, O'Connor TG, et al. No relationship between prenatal androgen exposure and autistic traits: convergent evidence from studies of children with congenital adrenal hyperplasia and of amniotic testosterone concentrations in typically developing children. J Child Psychol Psychiatry 2016;57(12):1455-62.https://doi.org/10.1111/jcpp.12602 Dawson G, Toth K, Abbott R, Osterling J, Munson J, Estes A, et al. Early social attention impairments in autism: social orienting, joint attention, and attention to distress. Dev Psychol 2004;40(2):271-83.https://doi.org/10.1037/0012-1649.40.2.271 Stevenson RA, Ruppel J, Sun SZ, Segers M, Zapparoli BL, Bebko JM, et al. Visual working memory and sensory processing in autistic children. Sci Rep 2021;11(1):3648.https://doi.org/10.1038/s41598-021-82777-1 Hollier LP, Keelan JA, Hickey M, Maybery MT, Whitehouse AJ. Measurement of androgen and estrogen concentrations in cord blood: accuracy, biological interpretation, and applications to understanding human behavioral development. Front Endocrinol (Lausanne) 2014;5:64.https://doi.org/10.3389/fendo.2014.00064 Nagamani M, McDonough PG, Ellegood JO, Mahesh VB. Maternal and amniotic fluid steroids throughout human pregnancy. Am J Obstet Gynecol 1979;134(6):674-80.https://doi.org/10.1016/0002-9378(79)90649-5 Vacher CM, Lacaille H, O'Reilly JJ, Salzbank J, Bakalar D, Sebaoui S, et al. Placental endocrine function shapes cerebellar development and social behavior. Nat Neurosci 2021;24(10):1392-401.https://doi.org/10.1038/s41593-021-00896-4 Cherskov A, Pohl A, Allison C, Zhang H, Payne RA, Baron-Cohen S. Polycystic ovary syndrome and autism: A test of the prenatal sex steroid theory. Transl Psychiatry 2018;8(1):136.https://doi.org/10.1038/s41398-018-0186-7 Berni TR, Morgan CL, Berni ER, Rees DA. Polycystic Ovary Syndrome Is Associated With Adverse Mental Health and Neurodevelopmental Outcomes. J Clin Endocrinol Metab 2018;103(6):2116-25.https://doi.org/10.1210/jc.2017-02667 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2933379","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":200863065,"identity":"926ca8d3-1809-4379-b9d6-5316ac586bf2","order_by":0,"name":"Dan Shen","email":"","orcid":"","institution":"Hangzhou Red Cross Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Dan","middleName":"","lastName":"Shen","suffix":""},{"id":200863066,"identity":"c37e9a89-7730-424a-87e4-25ed8165837c","order_by":1,"name":"Min-Chen Dai","email":"","orcid":"","institution":"Women’s Hospital, Zhejiang University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Min-Chen","middleName":"","lastName":"Dai","suffix":""},{"id":200863067,"identity":"c0da6de1-e240-4080-bb0e-eb4c7533fdce","order_by":2,"name":"Yue Jin","email":"","orcid":"","institution":"The First Affiliated Hospital, Zhejiang University School of Medicine","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yue","middleName":"","lastName":"Jin","suffix":""},{"id":200863068,"identity":"ee516080-f686-4b50-974d-371dec9a1c56","order_by":3,"name":"Zhou Jiang","email":"","orcid":"","institution":"Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhou","middleName":"","lastName":"Jiang","suffix":""},{"id":200863069,"identity":"1fa142bc-9b16-4af2-8eea-f6706a0526e5","order_by":4,"name":"Tian-Yi Zhou","email":"","orcid":"","institution":"Women’s Hospital, Zhejiang University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Tian-Yi","middleName":"","lastName":"Zhou","suffix":""},{"id":200863070,"identity":"73849f07-17bd-47fa-bb9f-036b39413dd6","order_by":5,"name":"Fan Qu","email":"","orcid":"","institution":"Women’s Hospital, Zhejiang University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fan","middleName":"","lastName":"Qu","suffix":""},{"id":200863071,"identity":"d1c7e2e0-8fd4-439c-9fd5-96b56f6be163","order_by":6,"name":"Fang-Fang Wang","email":"data:image/png;base64,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","orcid":"","institution":"Women’s Hospital, Zhejiang University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Fang-Fang","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2023-05-14 11:14:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2933379/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2933379/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":37268983,"identity":"6d63b329-fb0f-48c8-a4c6-63ba7115f831","added_by":"auto","created_at":"2023-05-20 07:44:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":423174,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2933379/v1/bf7440ff-ef17-48e0-9c45-96c910084f80.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The neurodevelopment of neonates born to women with polycystic ovary syndrome: evidences from China","fulltext":[{"header":"What is known","content":"\u003cp\u003eMothers with PCOS are at increased risk of gestational diabetes, hypertension, endothelial dysfunction and pre-eclampsia, which can alter the fetal endocrine environment, leading to adverse outcomes in offspring. The babies born to PCOS mothers had a significantly higher risk of admission to a neonatal intensive care unit and a higher perinatal mortality, unrelated to multiple births. A significantly higher prevalence of obesity, diabetes, cardiovascular disease was observed in offspring of women with PCOS, which could not be completely attributed to pregnancy complications, and seems to be more related to maternal PCOS condition, which our studies also lend support to.\u0026nbsp;Concerning neurobehavioral phenotypes, maternal PCOS has been reported to\u0026nbsp;respectively\u0026nbsp;increase the odds of offspring\u0026nbsp;attention-deficit/hyperactivity disorder (ADHD)\u0026nbsp;and\u0026nbsp;autism spectrum disorders (ASD)\u0026nbsp;by 42% and 59%.\u0026nbsp;Consistently, the previous work of the author\u0026rsquo;s group has suggested a different pattern of brain metrics in PCOS offspring in utero,\u0026nbsp;and\u0026nbsp;alterations of neurobehavioral phenotypes in female offspring of both women with PCOS and PCOS model rats which might involve learning and memory.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWhat is new:\u0026nbsp;\u003c/strong\u003eNeonatal behavioral neurological assessment (NBNA) was used as the measurement of neonates neurodevelopment in the current study, which was administered on the third day after birth. NBNA was invented by Bao et al based on the method of Brazelton and Amiel-Tison for behavioral neurological measurement in neonates as well as the clinical experiences in Chinese new-borns. The NBNA was tested with distinct stability and reliability by several large cohorts in China, and showed high consistency over various geographic locations .\u003c/p\u003e\n\u003cp\u003eIn the current study, total score of NBNA and score of behavioral capacity, orientation response-animate visual and auditory, were significantly lower in PCOS group than those in control group. Moreover, male neonates in PCOS group showed significantly lower total score of NBNA and score of behavioral capacity, especially orientation response-inanimate visual, than those in controls, while the female PCOS neonates did not. This result indicated that PCOS offspring probably showed social attention impairments, and that the male neonates of women with PCOS might have lower visual sensory ability of nonsocial information, which appeared as early as the beginning of the neonatal period. The possible explanation for sex difference in neurobehavior of PCOS offspring is that intrauterine androgen exposure in male PCOS offspring is most enhanced resulting from both maternal PCOS condition and fetal testicular function.\u0026nbsp;\u003c/p\u003e"},{"header":"INTRODUCTION","content":"\u003cp\u003ePolycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Women with PCOS exhibit heterogeneous features which involve reproductive, metabolic and psychological function [1, 2]. The specific gene mutations affecting androgen synthesis, insulin secretion and insulin activity explain most of the endocrine and metabolic symptoms, while environmental risk factors (during either prenatal or postnatal life), seem to convert an occult PCOS into a clinically manifest syndrome[3].\u003c/p\u003e\n\u003cp\u003eMothers with PCOS are at increased risk of gestational diabetes, hypertension, endothelial dysfunction and pre-eclampsia, which can alter the fetal endocrine environment, leading to adverse outcomes in offspring[4]. The babies born to PCOS mothers had a significantly higher risk of admission to a neonatal intensive care unit and a higher perinatal mortality, unrelated to multiple births[5]. A significantly higher prevalence of obesity, diabetes, cardiovascular disease was observed in offspring of women with PCOS, which could not be completely attributed to pregnancy complications, and seems to be more related to maternal PCOS condition[6-9], which our studies also lend support to[10-12]. Concerning neurobehavioral phenotypes, maternal PCOS has been reported to respectively increase the odds of offspring attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) by 42% and 59%[13-16]. Consistently, the previous work of the author\u0026rsquo;s group has suggested a different pattern of brain metrics in PCOS offspring in utero[17], and alterations of neurobehavioral phenotypes in female offspring of both women with PCOS[18] and PCOS model rats[19] which might involve learning and memory. Hence, further study is needed to confirm the role of maternal PCOS in early offspring neurodevelopment for both boys and girls.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eThe recruitment of pairs of mother and \u003c/strong\u003e\u003cstrong\u003eneonate and collection of clinical information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted between December 2016 and June 2017 in two hospitals in China, including Hangzhou Red Cross Hospital and Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University. Nineteen neonates born to mothers with PCOS and 38 neonates (as controls) born to the healthy mothers were recruited. Written informed consent was obtained from all the women. The study was approved by the Ethics Committee of Hangzhou Red Cross Hospital, Hangzhou, China. All mothers with PCOS were diagnosed according to the Rotterdam Consensus (European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine criteria)[20]. During recruitment, the mother\u0026rsquo;s age, body weight, height, pregnancy complication, parity, educational background and conception mode were noted. Birth mode, gestational week, gender, birth weight, serum bilirubin and Apagar score of neonates were recorded after birth. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssessment of growth and neurodevelopment status of \u003c/strong\u003e\u003cstrong\u003eneonates\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNeonatal behavioral neurological assessment (NBNA) was used as the measurement of neonates neurodevelopment in the current study, which was administered on the third day after birth. NBNA was invented by Bao et al[21] based on the method of Brazelton and Amiel-Tison for behavioral neurological measurement in neonates as well as the clinical experiences in Chinese new-borns. The NBNA was tested with distinct stability and reliability by several large cohorts in China, and showed high consistency over various geographic locations [22, 23].\u003c/p\u003e\n\u003cp\u003eThe NBNA assesses functional abilities, most reflexes and responses, and stability of behavioural status during the examination. It involves five scales: behavior (six items), passive tone (four items), active tone (four items), primary reflexes (three items), and general assessment (three items). Each above item has three dimensions of score (0, 1 and 2). Twenty items are summarized in the summary score with a maximum score of 40. Neonates with summary score more than 37 were considered to be well developed, and those with summary score more than 35 and lower than 37 were considered to be acceptable, otherwise neonates would probably be associated with poor clinical outcomes. Examiners were blinded with regard to exposure status when NBNA were carried out. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data were analyzed with SPSS Version 21.0. Independent sample t-test was used to compare variables approximately normally distributed, and a nonparametric test (Mann-Whitney U test) was used for variables with distributions other than normal. Numeration data were analyzed using chi-square test and Fisher\u0026rsquo;s exact test when the cell count was \u0026lt;5. P\u0026lt;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eBaseline clinical characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConcerning the mothers: age, BMI, duration of pregnancy, pregnancy complication, educational background and mode of delivery did not differ between two groups (all P\u0026gt;0.05, Table 1). However, mode of conception and parity differed significantly between two groups (P=0.010 and P=0.003, respectively, Table 1). Concerning the offspring: gender, birth weight, and Apgar score were comparable between two groups (all P\u0026gt;0.05, Table 1). After divided into subgroups based on neonatal gender, we observed comparable baseline clinical characteristics of both mothers and neonates (all P\u0026gt;0.05, Table 2) except mothers\u0026rsquo; parity in subgroup of male offspring and mode of conception in subgroup of female offspring (P=0.010 and P=0.023, respectively, Table 2).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1 Baseline clinical characteristics of pairs of mothers and neonates\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePCOS(n=19)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl(n=38)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e31.16\u0026plusmn;4.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e31.73\u0026plusmn;4.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e0.621\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e26.42\u0026plusmn;3.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e27.36\u0026plusmn;2.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eMode of conception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Natural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e15(78.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e38(100.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.010\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.275862068965516%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Ovulation induction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.28735632183908%\"\u003e\n \u003cp\u003e2(10.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.436781609195403%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.275862068965516%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;IVF/ICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.28735632183908%\"\u003e\n \u003cp\u003e2(10.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.436781609195403%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eGestational week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e39.65\u0026plusmn;1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e39.33\u0026plusmn;0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003ePregnancy complication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Gestational diabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e2(10.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e6(15.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e0.590\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Thyroid dysfunction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e4(21.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e4(10.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e0.500\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Group B streptococcal infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e2(10.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e1(2.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e0.529\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eParity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e1.22\u0026plusmn;0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e1.70\u0026plusmn;0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e0.003\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eEducational background\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e11(57.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e10(27.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.275862068965516%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;High school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.28735632183908%\"\u003e\n \u003cp\u003e6(31.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.436781609195403%\"\u003e\n \u003cp\u003e15(40.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.275862068965516%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Less than high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.28735632183908%\"\u003e\n \u003cp\u003e2(10.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.436781609195403%\"\u003e\n \u003cp\u003e12(32.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eMode of delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Vaginal delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e10(52.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e26(68.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.244\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.275862068965516%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Cesarean section delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.28735632183908%\"\u003e\n \u003cp\u003e9(47.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.436781609195403%\"\u003e\n \u003cp\u003e12(31.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOffspring\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eNeonatal gender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e10(52.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e18(47.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.708\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.275862068965516%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.28735632183908%\"\u003e\n \u003cp\u003e9(47.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.436781609195403%\"\u003e\n \u003cp\u003e20(52.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eBirth weight(g)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e3392.11\u0026plusmn;424.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e3426.32\u0026plusmn;321.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e0.735\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.857142857142854%\" valign=\"top\"\u003e\n \u003cp\u003eApgar score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.448979591836736%\"\u003e\n \u003cp\u003e10.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.46938775510204%\"\u003e\n \u003cp\u003e10.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Data were presented as mean\u0026plusmn;SD or number (percentage). \u003csup\u003e*\u003c/sup\u003eP\u0026lt;0.05, compared with control group; \u003csup\u003e#\u003c/sup\u003eP\u0026lt;0.01, compared with control group. \u003csup\u003e**\u003c/sup\u003eMissing data for one subject.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Baseline clinical characteristics of pairs of mothers and neonates in subgroups based on neonatal gender\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" rowspan=\"2\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.734693877551024%\" colspan=\"3\" style=\"width: 39.8605%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale offspring(n=28)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.673469387755105%\" colspan=\"3\" style=\"width: 33.7657%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale offspring(n=29)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.105263157894736%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePCOS(n=10)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.105263157894736%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl(n=18)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.157894736842104%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.105263157894736%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePCOS(n=9)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.789473684210526%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl(n=20)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.526315789473685%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e30.60\u0026plusmn;4.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e30.67\u0026plusmn;3.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e31.78\u0026plusmn;4.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e32.74\u0026plusmn;4.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.567\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e26.85\u0026plusmn;3.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e27.95\u0026plusmn;2.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e25.94\u0026plusmn;4.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e26.81\u0026plusmn;2.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.538\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eMode of conception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; Natural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e9(90.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e18(100.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" rowspan=\"3\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.357\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e6(66.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e20(100.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" rowspan=\"3\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.023\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.5%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Ovulation induction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e2(22.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.5%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;IVF/ICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e1(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e1(11.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eGestational week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e39.60\u0026plusmn;1.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e39.60\u0026plusmn;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.988\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e39.70\u0026plusmn;0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e39.09\u0026plusmn;1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.150\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003ePregnancy complication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; Gestational diabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e4(22.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e2(22.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e2(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.568\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; Thyroid dysfunction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e3(30.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e1(5.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e1(11.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e3(15.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; Group B streptococcal infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e1(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e1(5.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e1(11.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.310\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eParity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e1.20\u0026plusmn;0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e1.71\u0026plusmn;0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.010\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e1.25\u0026plusmn;0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e1.70\u0026plusmn;0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eEducational background\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e4(40.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e3(16.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" rowspan=\"3\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e7(77.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e7(36.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" rowspan=\"3\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.176\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.5%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; High school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e5(50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e9(50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e1(11.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e6(31.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.5%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; Less than high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e1(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e6(33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e1(11.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e6(31.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eMode of delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; Vaginal delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e4(40.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e8(44.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" rowspan=\"2\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e6(66.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e18(90.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" rowspan=\"2\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.5%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Cesarean section delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e6(60.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e10(55.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.25%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e3(33.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e2(10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOffspring\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eBirth weight(g)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e3565.00\u0026plusmn;323.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e3541.67\u0026plusmn;338.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e0.861\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e3200.00\u0026plusmn;456.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e3322.50\u0026plusmn;272.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e0.374\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.448979591836736%\" style=\"width: 20.6007%;\"\u003e\n \u003cp\u003eApgar score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e10.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 15.1153%;\"\u003e\n \u003cp\u003e10.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" style=\"width: 9.6299%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.26530612244898%\" style=\"width: 14.5058%;\"\u003e\n \u003cp\u003e10.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.244897959183673%\" style=\"width: 13.5306%;\"\u003e\n \u003cp\u003e10.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" style=\"width: 5.6073%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Data were presented as mean\u0026plusmn;SD or number (percentage). \u003csup\u003e*\u003c/sup\u003eP\u0026lt;0.05, compared with control group. \u003csup\u003e**\u003c/sup\u003e Missing data for one subject.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNeonatal neurodevelopment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTotal score of NBNA and score of behavioral capacity (especially in orientation response-animate visual and auditory) were significantly lower in PCOS group than those in control group (all P\u0026lt;0.05). In active muscle tension, passive muscle tension, primitive reflex and general status, NBNA score were comparable between two groups (all P\u0026gt;0.05, Table 3).\u003c/p\u003e\n\u003cp\u003eTo investigate the gender difference, we compared neonatal neurodevelopment between girls and boys in both PCOS and control groups.\u0026nbsp;On one hand, male neonates in PCOS group showed significantly lower total score of NBNA and score of behavioral capacity, especially orientation response-inanimate visual, than those in control group (all P\u0026lt;0.05), but there was no statistical difference between two groups in active muscle tension, passive muscle tension, primitive reflex and general status. On the other hand, female neonates were comparable in all items of NBNA score between PCOS and control groups (all P\u0026gt;0.05, Table 4). In addition, we found no statistical differences in all items of NBNA scores between female neonates and male neonates in both PCOS and control groups (all P\u0026gt;0.05, Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3 Comparison of NBNA between PCOS group and control group\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eItem\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePCOS(n=19)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl(n=38)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eTotal NBNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e36.68\u0026plusmn;1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e37.76\u0026plusmn;1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.001\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e8.84\u0026plusmn;1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e9.92\u0026plusmn;1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.001\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eAMT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e7.95\u0026plusmn;0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e7.97\u0026plusmn;0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.618\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003ePMT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e8.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e7.95\u0026plusmn;0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.317\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003ePR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e5.89\u0026plusmn;0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e5.92\u0026plusmn;0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.746\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eGS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e6.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e6.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eResponse decrement to light\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eResponse decrement to rattle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e1.84\u0026plusmn;0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.97\u0026plusmn;0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.158\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eOrientation response-inanimate auditory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e1.26\u0026plusmn;0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.53\u0026plusmn;0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eOrientation response-inanimate visual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e1.05\u0026plusmn;0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.21\u0026plusmn;0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eOrientation response-animate visual and auditory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e0.89\u0026plusmn;0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.24\u0026plusmn;0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.022\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eConsolability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e1.79\u0026plusmn;0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.97\u0026plusmn;0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eScarf sigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eRecoil of upper limbs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eRecoil of lower limbs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003ePopliteal angle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e1.95\u0026plusmn;0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.97\u0026plusmn;0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.618\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eRaise to sit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eHand grasp\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.95\u0026plusmn;0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.160\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003ePull reaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eRighting reaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eAutomatic walking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e1.89\u0026plusmn;0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e1.92\u0026plusmn;0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e0.746\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eMoro reflex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eSucking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eAlertness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eCrying\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"48.45360824742268%\" valign=\"top\"\u003e\n \u003cp\u003eActivity level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.649484536082475%\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.402061855670103%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Data were presented as mean\u0026plusmn;SD. \u003csup\u003e*\u003c/sup\u003eP\u0026lt;0.05, compared with control group; \u003csup\u003e#\u003c/sup\u003eP\u0026lt;0.01, compared with control group. AMT=active muscle tension, BC=behavioral capacity, GS=general status, NBNA=neonatal behavioral neurological assessment, PMT=passive muscle tension, PR=primitive reflex. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 Comparison of NBNA between PCOS group and control group based on neonatal gender\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" rowspan=\"2\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eItem\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" colspan=\"2\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePCOS(n=19)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" colspan=\"2\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl(n=38)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.125%\" colspan=\"4\" style=\"width: 21.2784%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.0625%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=9)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.0625%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=10)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.0625%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=20)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.0625%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=18)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePF vs. CF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.9375%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePM vs. CM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePF vs. PM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCF vs. CM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eTotal NBNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e36.67\u0026plusmn;1.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e36.70\u0026plusmn;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e37.65\u0026plusmn;1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e37.89\u0026plusmn;1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.006\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.950\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.502\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e9.00\u0026plusmn;1.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e8.70\u0026plusmn;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e9.80\u0026plusmn;1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e10.06\u0026plusmn;1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.001\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.472\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eAMT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e7.89\u0026plusmn;0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e8.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e8.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e7.94\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003ePMT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e8.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e8.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e7.95\u0026plusmn;0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e7.94\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.512\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.941\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003ePR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e5.78\u0026plusmn;0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e6.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e5.90\u0026plusmn;0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e5.94\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eGS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e6.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e6.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e6.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e6.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eResponse decrement to light\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eResponse decrement to rattle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.89\u0026plusmn;0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.80\u0026plusmn;0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.94\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.337\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.620\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eOrientation response-inanimate auditory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.33\u0026plusmn;0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.20\u0026plusmn;0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.50\u0026plusmn;0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.56\u0026plusmn;0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.422\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.740\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eOrientation response-inanimate visual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.22\u0026plusmn;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e0.90\u0026plusmn;0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.20\u0026plusmn;0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.22\u0026plusmn;0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.913\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.048\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.871\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eOrientation response-animate visual and auditory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e0.78\u0026plusmn;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.15\u0026plusmn;0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.33\u0026plusmn;0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.478\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eConsolability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.78\u0026plusmn;0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.80\u0026plusmn;0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.95\u0026plusmn;0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.294\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.912\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.350\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eScarf sigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eRecoil of upper limbs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eRecoil of lower limbs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003ePopliteal angle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.89\u0026plusmn;0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.94\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eRaise to sit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eHand grasp\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.95\u0026plusmn;0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.94\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.512\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.941\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003ePull reaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eRighting reaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eAutomatic walking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.78\u0026plusmn;0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.90\u0026plusmn;0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e1.94\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e0.395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eMoro reflex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eSucking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eAlertness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eCrying\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.914893617021278%\" style=\"width: 24.9262%;\"\u003e\n \u003cp\u003eActivity level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.574468085106384%\" style=\"width: 12.4023%;\"\u003e\n \u003cp\u003e2.00\u0026plusmn;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 6.3227%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.446808510638298%\" style=\"width: 5.5932%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" style=\"width: 4.7421%;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Data were presented as mean\u0026plusmn;SD. PF=PCOS female group, PM=PCOS male group, CF=control female group, CM=control male group, AMT=active muscle tension, BC=behavioral capacity, GS=general status, NBNA=neonatal behavioral neurological assessment, PMT=passive muscle tension, PR=primitive reflex. \u003csup\u003e*\u003c/sup\u003eP\u0026lt;0.05, significant difference;\u003csup\u003e\u0026nbsp;#\u003c/sup\u003eP\u0026lt;0.01, significant difference.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eLittle is known about the effects of maternal PCOS on fetal development[23]. During pregnancy, PCOS women have been shown to have increased blood androgen concentrations compared to control women[24]. This increase could affect the intrauterine androgen exposure of offspring. Female infants born to women with PCOS were found to have umbilical testosterone concentrations not only higher than control females but comparable to control males[25]. A positive association was found between elevated fetal testosterone in amniotic fluid and autistic features[26]. Elevated fetal testosterone in the mixture of arterial and venous umbilical cord blood also showed a high risk of language delay, particularly in male children[27]. Recent studies support the hypothesis that prenatal exposure to testosterone contributes to cognitive function development[28]. This would suggest that maternal PCOS with excess androgens, would increase the risk of ASD in the offspring[29].\u003c/p\u003e\n\u003cp\u003eASD is a set of heterogenous neurodevelopment conditions characterised by deficits in social communication, as well as severe anxiety and repetitive, restricted behaviour and interests[30-32], with worldwide prevalence of 1% to 2%[33-37]. The aetiology of autism is not fully understood, but genetics and early environmental factors can be the main causes of affecting the neurodevelopment[38-41]. Possible risk factors include advanced parental age[42, 43], exposure to chemicals[40, 44-47] and hormones[48-50] during pregnancy and perinatal and neonatal complications[39]. High prenatal fetal testosterone levels could affect the development of sexually dimorphic brain structures, thus lead to sex differences and autistic traits in individuals[51]. This idea is supported by the \u0026lsquo;extreme male brain of autism\u0026rsquo; theory[52] that extend the \u0026lsquo;empathising-systemising theory\u0026rsquo; in typical sex differences[53]. These theories argue that individuals with ASD have male-typical \u0026lsquo;systemising\u0026rsquo; cognitive abilities, considered as the drive to analyse and construct a system and less female-typical \u0026lsquo;empathising\u0026rsquo; profiles[52, 53]. Nevertheless, they were challenged by controversial evidence. Kung \u003cem\u003eet al\u003c/em\u003e. showed no evidence in their study testing autistic traits in children with congenital adrenal hyperplasia and typically developing children with amniotic fluid[54]. Considerable research has found that children with autism orient less frequently to both social and nonsocial stimuli than their peers[55]. ASD children showed distinct visual working memory and sensory processing[56].\u003c/p\u003e\n\u003cp\u003eIn the current study, total score of NBNA and score of behavioral capacity, orientation response-animate visual and auditory, were significantly lower in PCOS group than those in control group. Moreover, male neonates in PCOS group showed significantly lower total score of NBNA and score of behavioral capacity, especially orientation response-inanimate visual, than those in controls, while the female PCOS neonates did not. This result indicated that PCOS offspring probably showed social attention impairments, and that the male neonates of women with PCOS might have lower visual sensory ability of nonsocial information, which appeared as early as the beginning of the neonatal period. The possible explanation for sex difference in neurobehavior of PCOS offspring is that intrauterine androgen exposure in male PCOS offspring is most enhanced resulting from both maternal PCOS condition and fetal testicular function. \u003c/p\u003e\n\u003cp\u003eLimitations in the present study point to the direction of our future work. Firstly, increasing sample size is crucial to provide statistical power. This can be achieved by recruiting both more PCOS mothers and controls with an equal ratio of sons and daughters. Secondly, intrauterine androgen exposure of PCOS offspring should be further clarified. Currently, there is no established method that is both ethical and practical that can measure prenatal hormone exposure[57]. An ideal method could be through fetal blood collected during the critical period of neurodevelopment, but this is not feasible because of ethical reasons. Amniotic fluid is an alternative approach which probably reflects testosterone in fetal blood, but the sampling procedure (amniocentesis) is only performed for prenatal diagnosis for high-risk pregnancies[58]. In addition, intrauterine exposure of other endocrine factors besides androgen are also promising to give interpretation for the altered neurodevelopment of PCOS offspring[59].\u003c/p\u003e\n\u003cp\u003eTo sum up, the current study suggested an association between maternal PCOS and offspring neurobehavior at the beginning of neonatal period in a sex-specific manner. Our findings provide a clue for the mechanism underlying that prenatal androgen exposure impacts the neurodevelopment of offspring. However, our study is too small to answer whether early attention or intervention is required for children of PCOS mothers. It should be noted that children of PCOS mothers showed neurobehavior changes might related to autistic traits, but the risk of having children with ASD for PCOS women is still rare[13, 60, 61]. Therefore, the association between two conditions should not be overstated to avoid unnecessary stress on mothers with PCOS. Further research is required to understand the mechanisms of PCOS and ASD, as well as the involvement in fetal, maternal hormone levels and other conditions to optimise clinical interventions. \u003c/p\u003e"},{"header":"abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"659\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eAbbreviations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003eFull Name\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eADHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003eattention-deficit/hyperactivity disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eAMT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003eactive muscle tension\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eASD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003eautism spectrum disorders\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003ebehavioral capacity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eCF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003econtrol female group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eCM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003econtrol male group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eGS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003egeneral status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003eNBNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003eneonatal behavioral neurological assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003ePCOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003epolycystic ovarian syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003ePF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003ePCOS female group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003ePM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003ePCOS male group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003ePMT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003epassive muscle tension\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.747720364741642%\"\u003e\n \u003cp\u003ePR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"73.25227963525836%\"\u003e\n \u003cp\u003eprimitive reflex\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis study was supported by the Zhejiang Province Science Foundation for Key Program\u0026nbsp;[LZ21H270001 to F.Q.], the National Natural Science Foundation of China\u0026nbsp;[grant nos. 81874480 and 82074476 to F.Q.], and Zhejiang Traditional Chinese Medicine Foundation\u0026nbsp;[No.2021ZQ051 to Y.J.].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eC\u003c/strong\u003e\u003cstrong\u003eompeting\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eI\u003c/strong\u003e\u003cstrong\u003enterests\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;C\u003c/strong\u003e\u003cstrong\u003eontribution\u003c/strong\u003e\u003cstrong\u003es:\u0026nbsp;\u003c/strong\u003eConceptualization: Fan Qu, Fang-Fang Wang; Methodology: Fan Qu, Fang-Fang Wang; Formal analysis and investigation: Dan Shen,Min-Chen Dai; Writing - original draft preparation: Tian-Yi Zhou,Yue Jin; Writing- review and editing: Fan Qu, Fang-Fang Wang; Resources: Dan Shen, Zhou Jiang; Supervision: Fan Qu, Fang-Fang Wang.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval:\u0026nbsp;\u003c/strong\u003eThis study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the\u0026nbsp;Ethics Committee of Hangzhou Red Cross Hospital, Hangzhou, China.(Date\u0026nbsp;2016.12.16/No\u0026nbsp;[2016] 07)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate:\u0026nbsp;\u003c/strong\u003eInformed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish:\u003c/strong\u003e Patients signed informed consent regarding publishing their data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNorman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet 2007;370(9588):685-97.https://doi.org/10.1016/s0140-6736(07)61345-2 \u003c/li\u003e\n\u003cli\u003eRosenfield RL, Ehrmann DA. 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J Clin Endocrinol Metab 2018;103(6):2116-25.https://doi.org/10.1210/jc.2017-02667 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Polycystic ovary syndrome (PCOS), offspring, neurodevelopment","lastPublishedDoi":"10.21203/rs.3.rs-2933379/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2933379/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePolycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Mothers with PCOS are at increased risk of various gestational complications and adverse outcomes of offspring. The health problems, including neurobehavioral phenotypes, of PCOS offspring has attracted wide attention and been associated with intrauterine environment changes due to maternal PCOS. Using neonatal behavioral neurological assessment (NBNA), we conducted measurement of neonate\u0026rsquo;s neurodevelopment on the third day after birth. Total score of NBNA and score of behavioral capacity, orientation response-animate visual and auditory, were significantly lower in PCOS group than those in control group. Concerning sex difference, we found significantly lower total score of NBNA and score of behavioral capacity, orientation response-inanimate visual, in male neonates of PCOS group compared to those of control group, while this did not exist in female neonates. In conclusion, our data indicated an association between maternal PCOS and offspring neurobehavior at the beginning of neonatal period in a sex-specific manner. Further evidence of intrauterine environment is required to clarify the potential mechanism underlying impacts of maternal PCOS on neurodevelopment.\u003c/p\u003e","manuscriptTitle":"The neurodevelopment of neonates born to women with polycystic ovary syndrome: evidences from China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-05-18 08:33:47","doi":"10.21203/rs.3.rs-2933379/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bdb57377-4896-40be-b29f-5d8fcd3349f1","owner":[],"postedDate":"May 18th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-05-20T07:44:18+00:00","versionOfRecord":[],"versionCreatedAt":"2023-05-18 08:33:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2933379","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2933379","identity":"rs-2933379","version":["v1"]},"buildId":"GqpaHPwrfC8PjnIFayRh5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}