母亲慢性疾病与子代脑瘫风险：一项全国队列研究。
Maternal Chronic Conditions and Risk of Cerebral Palsy in Offspring: A National Cohort Study.
作者信息
Strøm Marianne S, Tollånes Mette C, Wilcox Allen J, Lie Rolv Terje, Forthun Ingeborg, Moster Dag
机构信息
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;
Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
出版信息
Pediatrics. 2021 Mar;147(3). doi: 10.1542/peds.2020-1137.
BACKGROUND AND OBJECTIVES
Previous studies suggest that children of mothers with certain chronic conditions may be at increased risk of cerebral palsy (CP). We explored possible associations between 17 maternal chronic conditions and CP in offspring.
METHODS
We conducted a prospective cohort study of Norwegian children born in 1990-2012 and surviving to 2 years of age. Information on maternal chronic conditions during pregnancy were extracted from the Medical Birth Registry of Norway (1990-2012). Information on chronic conditions in mothers and fathers recorded in the Norwegian Patient Registry (2008-2014) was available for a subset of children. CP diagnoses were extracted from the National Insurance Scheme (1990-2014) and the Norwegian Patient Registry (2008-2014). We estimated relative risks (RRs) and 95% confidence intervals (CIs) of CP in offspring of parents with chronic conditions compared with the general population using log binominal regression models.
RESULTS
A total of 1 360 149 Norwegian children, including 3575 children with CP (2.6 per 1000 live births), fulfilled the inclusion criteria. The highest risk of CP was among offspring of mothers with type 2 diabetes (RR 3.2; 95% CI 1.8-5.4), lupus erythematosus (RR 2.7; 95% CI 0.9-8.3), type 1 diabetes (RR 2.2; 95% CI 1.4-3.4), and Crohn disease (RR 2.1; 95% CI 1.0-4.1) during pregnancy. No increased risks were seen for offspring of fathers with chronic conditions.
CONCLUSIONS
Several maternal chronic conditions were associated with increased risk of CP in offspring. Maternal autoimmune disorders carried a particular risk.
背景与目的
既往研究表明，患有某些慢性疾病的母亲所生子女患脑瘫（CP）的风险可能会增加。我们探讨了17种母亲慢性疾病与后代患CP之间可能存在的关联。
方法
我们对1990 - 2012年出生且存活至2岁的挪威儿童进行了一项前瞻性队列研究。孕期母亲慢性疾病的信息从挪威医疗出生登记处（1990 - 2012年）提取。挪威患者登记处（2008 - 2014年）记录的母亲和父亲慢性疾病信息可用于部分儿童。CP诊断信息从国家保险计划（1990 - 2014年）和挪威患者登记处（2008 - 2014年）提取。我们使用对数二项回归模型估计患有慢性疾病的父母所生后代患CP的相对风险（RRs）和95%置信区间（CIs），并与一般人群进行比较。
结果
共有1360149名挪威儿童符合纳入标准，其中包括357名患有CP的儿童（每1000例活产中有2.6例）。患CP风险最高的是孕期患有2型糖尿病的母亲所生后代（RR 3.2；95% CI 1.8 - 5.4）、红斑狼疮（RR 2.7；95% CI 0.9 - 8.3）、1型糖尿病（RR 2.2；95% CI 1.4 - 3.4）和克罗恩病（RR 2.1；95% CI 1.0 - 4.1）的母亲所生后代。患有慢性疾病的父亲所生后代未观察到风险增加。
结论
几种母亲慢性疾病与后代患CP的风险增加有关。母亲自身免疫性疾病具有特别的风险。
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