母亲糖尿病与后代自闭症的关联
Anny H Xiang1, Xinhui Wang1, Mayra P Martinez1
1Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
JAMA
|April 15, 2015
概括
在怀孕早期 (26周前) 确诊的孕产妇妊娠糖尿病 (GDM) 与儿童患自闭症谱系障碍 (ASD) 的风险增加有关. 经过调整后,先前存在的2型糖尿病没有显著的关联.
科学领域:
- 生殖医学 生殖医学
- 发育神经科学的发展神经科学.
- 流行病学 流行病学
背景情况:
- 关于母亲糖尿病和自闭症谱系障碍 (ASD) 之间的关联存在有限的数据.
- 怀孕期间糖尿病暴露时间对ASD风险的影响尚不清楚.
研究的目的:
- 调查暴露于先前存在的2型糖尿病或妊娠糖尿病 (GDM) 的后代中ASD风险.
- 为了确定怀孕期间GDM诊断的时间是否会影响ASD风险.
主要方法:
- 一项回顾性纵向队列研究分析了1995年至2009年期间的322,323例单独出生.
- 母亲暴露包括先前存在的2型糖尿病,早期诊断的GDM (≤26周),晚期诊断的GDM (>26周) 和没有糖尿病.
- 儿童被追踪到ASD诊断,使用Cox回归模型估计了相对风险.
主要成果:
- 怀孕26周诊断的孕产妇GDM在完全调整后与ASD风险增加1.42倍 (HR,1.42;95% CI,1.15-1.74) 相联系.
- 在完全调整后,母亲先前存在的2型糖尿病与ASD风险没有显著的关联 (HR,1.21;95% CI,0.97-1.52).
- 怀孕26周后诊断的GDM没有增加ASD风险 (HR,0.98;95%CI,0.84-1.15)
结论:
- 早期妊娠期糖尿病 (26周前) 是子女自闭症谱系障碍的重要危险因素.
- 诊断GDM的时间对于了解其与ASD风险的关联至关重要.
- 这些发现强调了在怀孕早期管理GDM的重要性.
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