JAMA:妊娠期糖尿病可能增加后代ASD风险

2015-04-16 徐媛媛译 MedSci原创

目前,关于妊娠期糖尿病与孤独症谱系障碍(ASDs)之间关系的研究很有限。本研究评估母体糖尿病(包括妊娠期糖尿病及孕前糖尿病)与儿童ASD发病风险之间的关系。 我们收纳了来自凯萨医疗南加州(KPSC)医院1995-2009年间出生的322323名儿童医疗信息(从出生到第一次随访期间),其中包括:ASD临床诊断日期、KPSC健康计划会员身份的持续时间、截至死亡或2012年12月31日等有关数据。使用

目前,关于妊娠期糖尿病与孤独症谱系障碍(ASDs)之间关系的研究很有限。本研究评估母体糖尿病(包括妊娠期糖尿病及孕前糖尿病)与儿童ASD发病风险之间的关系。

我们收纳了来自凯萨医疗南加州(KPSC)医院1995-2009年间出生的322323名儿童医疗信息(从出生到第一次随访期间),其中包括:ASD临床诊断日期、KPSC健康计划会员身份的持续时间、截至死亡或2012年12月31日等有关数据。使用Cox回归模型调整出生时间来评估ASD的相对风险比(HRs)。

我们收纳了6496名孕前II型糖尿病患者,妊娠26周或更早被诊断GDM患者7456名或妊娠26周后被诊断GDM的患者17579名,或妊娠期没有糖尿病290290名。在随访期间,有3388名儿童被诊断为ASD(胎儿期暴露先存II型糖尿病者115名,胎儿期≤26周暴露GDM者130名,胎儿期≥26周暴露GDM者180名,2963名无暴露)。

未经调整每1000儿童胎儿期暴露于先存II型糖尿病、妊娠26周或更早存II型糖尿病、26周后GDM和无糖尿病组ASD发病率分别为3.26,3.26,3.02和1.77。调整出生时间后的先存II型糖尿病HRs为1.59(95% CI,1.29-1.95),妊娠26周或更早存于II型糖尿病为1.63(95% CI,1.35 - -1.97)和26周后GDM和无糖尿病为0.98(95% CI,0.84 - -1.15)。调整母亲生育年龄、家庭收入,儿童的种族、性别后,妊娠26周被诊断GDM与后代ASD风险明显相关 (HR, 1.21; 95% CI, 0.97-1.52),但孕前先存II型糖尿病对ASD风险无影响 (HR, 1.42; 95% CI, 1.15-1.74)。抗糖尿病药物不是后代ASD风险的独立相关因素。母亲吸烟、孕前体重指数、妊娠期体重增加不影响结果。

研究结果表明:在这项临床队列研究中,妊娠26周时宫内暴露孕期糖尿病发病风险与孤独症谱系障碍(ASDs)风相关。母体的孕前先存II型糖尿病与后代ASD风险无明显相关性。

原始出处

Xiang AH1, Wang X1, Martinez MP1, Walthall JC2, Curry ES3, Page K4, Buchanan TA5, Coleman KJ1, Getahun D6.Association of Maternal Diabetes With Autism in Offspring.JAMA. 2015 Apr 14

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    2016-03-01 okhuali
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    2015-06-11 ljjj1053

    好好学习一下

    0

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    2015-04-18 仁医06
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