World Health Organization Collaborating Centre in Human Reproduction, Universidad del Valle, Cali, Colombia; and
World Health Organization Collaborating Centre in Human Reproduction, Universidad del Valle, Cali, Colombia; and.
Pediatrics. 2016 May;137(5). doi: 10.1542/peds.2015-3482. Epub 2016 Apr 7.
Both short and long interpregnancy intervals (IPIs) have recently been associated with increased risk of autism spectrum disorder (ASD). However, this association has not been systematically evaluated.
To examine the relationship between birth spacing and the risk of ASD and other neurodevelopmental disabilities.
Electronic databases from their inception to December 2015, bibliographies, and conference proceedings.
Observational studies with results adjusted for potential confounding factors that reported on the association between IPIs or birth intervals and neurodevelopmental disabilities.
Two reviewers independently extracted data on study characteristics, IPIs/birth intervals, and outcome measures.
Seven studies (1 140 210 children) reported an association between short IPIs and increased risk of ASD, mainly the former subtype autistic disorder. Compared with children born to women with IPIs of ≥36 months, children born to women with IPIs of <12 months had a significantly increased risk of any ASD (pooled adjusted odds ratio [OR] 1.90, 95% confidence interval [CI] 1.16-3.09). This association was stronger for autistic disorder (pooled adjusted OR 2.62, 95% CI 1.53-4.50). Three of these studies also reported a significant association between long IPIs and increased risk of ASD. Short intervals were associated with a significantly increased risk of developmental delay (3 studies; 174 940 children) and cerebral palsy (2 studies; 19 419 children).
Substantial heterogeneity, and few studies assessing neurodevelopmental disabilities other than ASD.
Short IPIs are associated with a significantly increased risk of ASD. Long IPIs also appear to increase the risk of ASD.
近期研究表明，妊娠间隔过短和过长与自闭症谱系障碍（ASD）风险增加相关。然而，这种关联尚未得到系统评估。
评估生育间隔与 ASD 及其他神经发育障碍风险之间的关系。
自建库起至 2015 年 12 月的电子数据库、参考文献和会议记录。
观察性研究，结果经潜在混杂因素校正，报告了妊娠间隔与神经发育障碍之间的关联。
两名评审员独立提取研究特征、妊娠间隔和结局测量方面的数据。
7 项研究（1140210 名儿童）报告了短妊娠间隔与 ASD 风险增加之间的关联，主要是前孤独症障碍亚型。与间隔≥36 个月的女性所生儿童相比，间隔<12 个月的女性所生儿童 ASD 风险显著增加（汇总校正优势比[OR] 1.90，95%置信区间[CI] 1.16-3.09）。这种关联在孤独症障碍中更强（汇总校正 OR 2.62，95% CI 1.53-4.50）。其中 3 项研究还报告了长妊娠间隔与 ASD 风险增加之间存在显著关联。短间隔与发育迟缓（3 项研究；174940 名儿童）和脑瘫（2 项研究；19419 名儿童）的风险显著增加相关。
存在较大异质性，且评估 ASD 以外的神经发育障碍的研究较少。
短妊娠间隔与 ASD 风险显著增加相关。长妊娠间隔似乎也会增加 ASD 的风险。
