Koks Natasja, Ghassabian Akhgar, Greaves-Lord Kirstin, Hofman Albert, Jaddoe Vincent W V, Verhulst Frank C, Tiemeier Henning
The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Paediatr Perinat Epidemiol. 2016 Mar;30(2):181-9. doi: 10.1111/ppe.12261. Epub 2015 Dec 3.
Exposure to elevated levels of inflammatory markers during pregnancy has been suggested as possible aetiologic factor in the occurrence of autism spectrum disorder (ASD). In this study, we investigated the prospective relation between maternal C-reactive protein (CRP) during early pregnancy and children's autistic traits in the general population.
In a large population-based cohort in the Netherlands, we measured maternal CRP levels before 18 weeks of gestation (N = 4165). Parents reported on their children's autistic traits at age 6 years using the Social Responsiveness Scale, and the Pervasive Developmental Problem scale. Regression models were used to examine the relation between maternal CRP levels and autistic traits in children.
Compared with the reference group (CRP < 2.3 mg/L), elevated levels of CRP (>7.8 mg/L) in pregnant women were associated with higher Social Responsiveness Scale scores in children [β = 0.055, 95% confidence interval (CI) 0.033, 0.078]; however, the effect was strongly attenuated after adjustment for several socioeconomic factors and in particular by maternal health-related factors including body mass index (fully adjusted model β = 0.018, 95% CI -0.005, 0.042). We found no relation between maternal CRP levels and pervasive developmental problem.
Our results suggest that the association between elevated levels of maternal CRP in pregnancy and autistic traits in children is confounded by maternal health-related and socioeconomic factors. Further studies are needed to explore whether other maternal inflammatory markers during pregnancy, as a response to maternal inflammation, are associated with the development of autistic traits in the offspring.
孕期暴露于高水平炎症标志物被认为可能是自闭症谱系障碍(ASD)发生的病因。在本研究中,我们调查了孕早期母体C反应蛋白(CRP)与普通人群中儿童自闭症特征之间的前瞻性关系。
在荷兰一个基于人群的大型队列中,我们测量了妊娠18周前母体的CRP水平(N = 4165)。父母使用社会反应量表和广泛性发育问题量表报告其孩子6岁时的自闭症特征。采用回归模型研究母体CRP水平与儿童自闭症特征之间的关系。
与参考组(CRP<2.3mg/L)相比,孕妇CRP水平升高(>7.8mg/L)与儿童较高的社会反应量表得分相关[β = 0.055,95%置信区间(CI)0.033,0.078];然而,在调整了几个社会经济因素,特别是包括体重指数在内的与母体健康相关的因素后,这种效应显著减弱(完全调整模型β = 0.018,95%CI -0.005,0.042)。我们发现母体CRP水平与广泛性发育问题之间没有关系。
我们的结果表明,孕期母体CRP水平升高与儿童自闭症特征之间的关联受到与母体健康相关和社会经济因素的混杂影响。需要进一步研究来探讨孕期其他母体炎症标志物作为对母体炎症的反应,是否与后代自闭症特征的发展相关。