产前暴露于抗生素与后代神经发育障碍风险：一项系统评价和荟萃分析。
Prenatal exposure to antibiotics and risk of neurodevelopmental disorders in offspring: A systematic review and meta-analysis.
作者信息
Tao Qiuji, Shen Yajun, Li Yang, Luo Huan, Yuan Meng, Gan Jing
机构信息
Department of Pediatrics of Neurology Nursing, West China School of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
出版信息
Front Neurol. 2022 Nov 25;13:1045865. doi: 10.3389/fneur.2022.1045865. eCollection 2022.
BACKGROUND AND PURPOSE
A growing body of research suggests that inflammation and maternal infections may lead to an increased risk of neurodevelopmental problems such as attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), cerebral palsy (CP), and epilepsy in offspring. The aim of this study was to observe the connection between prenatal antibiotic exposure and the risk of these neurodevelopmental disorders in offspring.
PATIENTS AND METHODS
A comprehensive search was conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Google Scholar, and Scopus databases for observational studies that looked into the link between prenatal exposure to antibiotics and the risk of neurodevelopmental problems in offspring, published from 1 January 1950 to 31 January 2022. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Data were analyzed using the STATA version 12 software, and an odds ratio (OR) with a 95% confidence interval (CI) was reported.
RESULTS
A total of 15 studies were included in the meta-analysis. Prenatal antibiotic exposure was associated with the increased risk of ADHD (OR = 1.14; 95% CI = 1.13 to 1.15; = 0%) and epilepsy (OR = 1.34; 95% CI = 1.02 to 1.66; = 96.8%). The link between prenatal antibiotic exposure and the risk of ASD [OR = 1.09; 95 % CI = 0.88 to 1.31; = 78.9%] and CP [OR = 0.99; 95% CI = 0.56 to 1.43; = 91%] was found to be non-significant. In all of the included prospective cohort studies, subgroup analysis suggested a significant association between prenatal antibiotic exposure and the incidence of ASD [OR = 1.17; 95% CI = 1.03 to 1.31; = 48.1%] and CP [OR = 1.18; 95% CI = 1.02 to 1.34; = 0%].
CONCLUSION
Prenatal antibiotic exposure during pregnancy is linked to a higher incidence of ADHD and epilepsy in the offspring. Further prospective studies that compare prenatal antibiotic use and are adjusted for various confounders are needed to further assess the association of prenatal antibiotic exposure and neurological disorders in offspring.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier: CRD42022306248.
背景与目的
越来越多的研究表明，炎症和母体感染可能会增加后代患神经发育问题的风险，如注意力缺陷多动障碍（ADHD）、自闭症谱系障碍（ASD）、脑瘫（CP）和癫痫。本研究的目的是观察产前抗生素暴露与后代这些神经发育障碍风险之间的联系。
患者与方法
在考克兰对照试验中心注册库（CENTRAL）、PubMed、谷歌学术和Scopus数据库中进行了全面检索，以查找1950年1月1日至2022年1月31日发表的关于产前抗生素暴露与后代神经发育问题风险之间联系的观察性研究。使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。使用STATA 12版软件进行数据分析，并报告比值比（OR）及其95%置信区间（CI）。
结果
荟萃分析共纳入15项研究。产前抗生素暴露与ADHD风险增加相关（OR = 1.14；95%CI = 1.13至1.15；P = 0%）和癫痫风险增加相关（OR = 现1.34；95%CI = 1.02至1.66；P = 96.8%）。产前抗生素暴露与ASD风险[OR = 1.09；95%CI = 0.88至1.31；P = 78.9%]和CP风险[OR = 0.99；95%CI = 0.56至1.43；P = 91%]之间的联系不显著。在所有纳入的前瞻性队列研究中，亚组分析表明产前抗生素暴露与ASD发病率[OR = 1.17；95%CI = 1.03至1.31；P = 48.1%]和CP发病率[OR = 1.18；95%CI = 1.02至1.34；P = 0%]之间存在显著关联。
结论
孕期产前抗生素暴露与后代中ADHD和癫痫的较高发病率有关。需要进一步的前瞻性研究来比较产前抗生素的使用情况，并对各种混杂因素进行调整，以进一步评估产前抗生素暴露与后代神经疾病之间的关联。
系统评价注册
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