孕产妇怀孕结果和后代患成年发病多发性硬化症的风险
Katrin Wolfova1,2, Bo Lars Engdahl3, Julie Horn4,5
1Department of Neurology, Columbia University, Presbyterian Hospital, New York, New York.
JAMA neurology
|January 12, 2026
概括
孕产妇糖尿病和出生时比妊娠年龄大 (LGA) 增加了成人发病多发性硬化症 (MS) 的风险. 相反,出生时的妊娠年龄 (SGA) 较小与MS的风险较低有关. 这些发现突出了对MS易感性的潜在产前影响.
科学领域:
- 神经学 神经学
- 产科和妇科 产科和妇科
- 流行病学 流行病学
背景情况:
- 双胞胎多发性硬化症 (MS) 协同率表明产前和产周因素影响风险.
- 很少有大规模的研究研究了母亲怀孕不良结果对后代多发性硬化症风险的影响.
研究的目的:
- 检查妊娠不良结果与后代患成年期多发性硬化症 (MS) 风险之间的关联.
- 研究过早分娩,对于妊娠年龄来说小 (SGA),对于妊娠年龄来说大 (LGA),妊娠高血压障碍 (HDP),胎盘断裂和母体糖尿病.
主要方法:
- 一项封闭的队列研究利用了挪威的国家登记册,包括1967年至1989年超过130万活产婴儿.
- 考克斯模型估计了18岁以上个体的怀孕结果和MS之间的关联.
- 从2009年到2019年进行了随访,确定了4,295例多发性硬化病例.
主要成果:
- 对于妊娠年龄来说出生大 (LGA) 与MS风险增加13% (HR1.13,95% CI1.03-1.25) 相关.
- 母亲糖尿病暴露显示MS的风险增加了2.15倍 (HR2.15,95%CI1.37至3.37).
- 对于妊娠年龄 (SGA) 的出生小与MS风险降低有关 (HR 0.88,95% CI 0.78-0.98). 早产,HDP和胎盘断裂与多发性硬化风险没有显著关联.
结论:
- 怀孕不良后果,特别是LGA出生和孕产妇糖尿病,与成人多发性硬化症风险增加有关.
- SGA出生可能与MS的风险降低有关.
- 研究结果表明,对MS的敏感性可能起源于产前期,这强调了怀孕健康对神经发育结果的重要性.
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