Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.
Obes Rev. 2018 Apr;19(4):464-484. doi: 10.1111/obr.12643. Epub 2017 Nov 22.
This review examined evidence of the association between maternal pre-pregnancy overweight/obesity status and child neurodevelopmental outcomes. PubMed and PsycINFO databases were systematically searched for empirical studies published before April 2017 using keywords related to prenatal obesity and children's neurodevelopment. Of 1483 identified papers, 41 were included in the systematic review, and 32 articles representing 36 cohorts were included in the meta-analysis. Findings indicated that compared with children of normal weight mothers, children whose mothers were overweight or obese prior to pregnancy were at increased risk for compromised neurodevelopmental outcomes (overweight: OR = 1.17, 95% CI [1.11, 1.24], I = 65.51; obese: OR = 1.51; 95% CI [1.35, 1.69], I = 79.63). Pre-pregnancy obesity increased the risk of attention deficit-hyperactivity disorder (OR = 1.62; 95% CI [1.23, 2.14], I = 70.15), autism spectrum disorder (OR = 1.36; 95% CI [1.08, 1.70], I = 60.52), developmental delay (OR = 1.58; 95% CI [1.39, 1.79], I = 75.77) and emotional/behavioural problems (OR = 1.42; 95% CI [1.26, 1.59], I = 87.74). Given the current obesity prevalence among young adults and women of childbearing age, this association between maternal obesity during pregnancy and atypical child neurodevelopment represents a potentially high public health burden.
本综述考察了母亲孕前超重/肥胖状况与儿童神经发育结局之间关联的证据。系统检索了PubMed 和 PsycINFO 数据库,以与产前肥胖和儿童神经发育相关的关键词,查找截至 2017 年 4 月发表的实证研究。在 1483 篇确定的论文中,有 41 篇被纳入系统综述,有 32 篇文章代表 36 个队列被纳入荟萃分析。结果表明,与正常体重母亲的儿童相比,孕前超重或肥胖母亲的儿童神经发育结局受损的风险增加(超重:OR=1.17,95%CI[1.11, 1.24],I²=65.51%;肥胖:OR=1.51;95%CI[1.35, 1.69],I²=79.63%)。孕前肥胖增加了注意力缺陷多动障碍(OR=1.62;95%CI[1.23, 2.14],I²=70.15%)、自闭症谱系障碍(OR=1.36;95%CI[1.08, 1.70],I²=60.52%)、发育迟缓(OR=1.58;95%CI[1.39, 1.79],I²=75.77%)和情绪/行为问题(OR=1.42;95%CI[1.26, 1.59],I²=87.74%)的风险。鉴于当前年轻人和育龄妇女的肥胖流行率,这种怀孕期间母亲肥胖与儿童神经发育异常之间的关联代表了一个潜在的高公共卫生负担。