产前葡萄糖不耐症和儿童神经发育障碍
Luke P Grosvenor1, Erica P Gunderson1,2, Yinge Qian1
1Division of Research, Kaiser Permanente Northern California, Pleasanton.
JAMA network open
|November 5, 2025
概括
妊娠期糖尿病 (GDM) 与神经发育障碍 (NDD) 相关,具体与妊娠期间发生GDM以及孩子的性别有关. 葡萄糖耐受性损害 (IGT) 也显示了与NDD的性别特异性关联.
科学领域:
- 产科和妇科 产科和妇科
- 儿科 儿科 儿科
- 神经科学是一个神经科学.
背景情况:
- 孕期糖尿病 (GDM) 是已知的儿童神经发育不良结果的危险因素.
- 了解这些关联的具体时间和基于性别的差异对于有针对性的预防和干预策略至关重要.
研究的目的:
- 调查产前葡萄糖不耐受,包括GDM和葡萄糖耐受性损失 (IGT) 与后代神经发育障碍 (NDD) 风险之间的关联.
- 检查GDM诊断的妊娠时间和孩子的性别如何改变这些关联.
主要方法:
- 一项以人口为基础的病例控制研究,利用北加利福尼亚州母婴对的电子健康记录.
- 孕妇糖尿病被按妊娠时间 (早期,标准,晚期) 分类,IGT被定义为高血糖查测试,没有诊断GDM.
- 从医疗记录中确定了神经发育障碍,包括自闭症谱系障碍 (ASD) 和发育迟缓. 使用多变量逻辑回归模型来估计调整的几率比率 (aOR),根据GDM时间和孩子的性别评估效果修改.
主要成果:
- 总的来说,GDM与ASD或发育迟缓的概率增加没有显著的关联.
- 然而,GDM与特别在女性中ASD几率增加有关 (aOR,2.05),早期GDM与女性ASD几率增加有关 (aOR,3.23).
- 产前IGT仅与女性发育迟缓的几率增加有关 (aOR, 3.25).
结论:
- GDM和NDD之间的关联取决于妊娠时间和孩子的性别,突出了特定性别的脆弱性.
- 产前IGT还表明与发育迟缓的性别特异性关联,加强了母亲葡萄糖代谢对儿童神经发育的影响.
- 这些发现强调了在怀孕期间考虑母亲健康的重要性,以优化儿童神经发育结果.
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