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4 岁以下患有妊娠糖尿病的女性所生孩子存在神经发育迟缓:日本环境与儿童研究。

Neurodevelopmental delay up to the age of 4 years in infants born to women with gestational diabetes mellitus: The Japan Environment and Children's Study.

机构信息

Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan.

出版信息

J Diabetes Investig. 2022 Dec;13(12):2054-2062. doi: 10.1111/jdi.13907. Epub 2022 Sep 22.

Abstract

AIMS/INTRODUCTION: This study aimed to investigate the neurodevelopment of infants born to women with gestational diabetes mellitus (GDM).

MATERIALS AND METHODS

Data from the National Birth Cohort in the Japan Environment and Children's Study from 2011 to 2014 (n = 81,705) were used. Japan uses the GDM guidelines of the International Association of Diabetes and Pregnancy Study Groups. The Japanese translation of the Ages and Stages Questionnaires, third Edition, was used to assess neurodevelopment in the following domains: communication skills, gross motor skills, fine motor skills, problem-solving ability, and personal and social skills. The survey was carried out every 6 months from the age of 6 months to 4 years (total of eight times). Generalized estimating equations were used to evaluate the association between maternal GDM and neurodevelopmental delay based on odds ratios (ORs) and 95% confidence intervals (95% CIs).

RESULTS

Neurodevelopmental delays, particularly in problem-solving ability, fine motor skills, and personal and social skills, were significantly higher in infants born to women with GDM than in those born to women without GDM (adjusted OR 1.24, 95% CI 1.12-1.36; adjusted OR 1.15, 95% CI 1.03-1.27; and adjusted OR 1.18, 95% CI 1.04-1.33). Furthermore, stratification showed no significant increase in the adjusted ORs (95% CIs) of girls.

CONCLUSIONS

Neurodevelopment was significantly delayed up to 4 years-of-age among boys born to women with GDM.

摘要

目的/引言:本研究旨在调查患有妊娠糖尿病(GDM)的女性所生婴儿的神经发育情况。

材料和方法

使用了 2011 年至 2014 年日本环境与儿童研究国家出生队列的数据(n=81705)。日本采用国际糖尿病与妊娠研究组的 GDM 指南。使用《年龄与阶段问卷》第三版对沟通技巧、粗大运动技能、精细运动技能、解决问题能力以及个人和社交技能等领域进行神经发育评估。调查从 6 个月大开始,每 6 个月进行一次,持续到 4 岁(共 8 次)。使用广义估计方程评估母亲 GDM 与神经发育迟缓之间的关联,依据的是比值比(ORs)和 95%置信区间(95% CIs)。

结果

患有 GDM 的女性所生婴儿的神经发育迟缓,尤其是在解决问题能力、精细运动技能和个人与社交技能方面,明显高于没有 GDM 的女性所生婴儿(校正 OR 1.24,95% CI 1.12-1.36;校正 OR 1.15,95% CI 1.03-1.27;校正 OR 1.18,95% CI 1.04-1.33)。此外,分层分析显示,女孩的校正 OR(95% CI)没有显著增加。

结论

患有 GDM 的女性所生男孩的神经发育在 4 岁时明显延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a403/9720201/9d8e1630df98/JDI-13-2054-g001.jpg

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