Wiegersma Aline Marileen, Boots Amber, Langendam Miranda W, Limpens Jacqueline, Shenkin Susan D, Korosi Aniko, Roseboom Tessa J, de Rooij Susanne R
Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2025 May;60(5):977-991. doi: 10.1007/s00127-023-02471-7. Epub 2023 Apr 8.
Prenatal factors such as maternal stress, infection and nutrition affect fetal brain development and may also influence later risk for dementia. The purpose of this systematic review was to provide an overview of all studies which investigated the association between prenatal factors and later risk for dementia.
We systematically searched MEDLINE and Embase for original human studies reporting on associations between prenatal factors and dementia from inception to 23 November 2022. Prenatal factors could be any factor assessed during pregnancy, at birth or postnatally, provided they were indicative of a prenatal exposure. Risk of bias was assessed using the Newcastle Ottawa Scale. We followed PRISMA guidelines for reporting.
A total of 68 studies met eligibility criteria (including millions of individuals), assessing maternal age (N = 30), paternal age (N = 22), birth order (N = 15), season of birth (N = 16), place of birth (N = 13), prenatal influenza pandemic (N = 1) or Chinese famine exposure (N = 1), birth characteristics (N = 3) and prenatal hormone exposure (N = 4). We observed consistent results for birth in a generally less optimal environment (e.g. high infant mortality area) being associated with higher dementia risk. Lower and higher birth weight and prenatal famine exposure were associated with higher dementia risk. The studies on season of birth, digit ratio, prenatal influenza pandemic exposure, parental age and birth order showed inconsistent results and were hampered by relatively high risk of bias.
Our findings suggest that some prenatal factors, especially those related to a suboptimal prenatal environment, are associated with an increased dementia risk. As these associations may be confounded by factors such as parental socioeconomic status, more research is needed to examine the potential causal role of the prenatal environment in dementia.
诸如母亲压力、感染和营养等产前因素会影响胎儿大脑发育，也可能影响日后患痴呆症的风险。本系统评价的目的是概述所有调查产前因素与日后患痴呆症风险之间关联的研究。
我们系统检索了MEDLINE和Embase数据库，以查找从数据库建立至2022年11月23日期间报告产前因素与痴呆症之间关联的原始人体研究。产前因素可以是孕期、出生时或产后评估的任何因素，只要它们表明存在产前暴露。使用纽卡斯尔渥太华量表评估偏倚风险。我们遵循PRISMA指南进行报告。
共有68项研究符合纳入标准（涉及数百万个体），评估了母亲年龄（N = 30）、父亲年龄（N = 22）、出生顺序（N = 15）、出生季节（N = 16）、出生地（N = 13）、产前流感大流行（N = 1）或中国饥荒暴露（N = 1）、出生特征（N = 3）和产前激素暴露（N = 4）。我们观察到，在通常不太理想的环境中出生（例如婴儿死亡率高的地区）与患痴呆症的风险较高相关，结果一致。出生体重较低和较高以及产前饥荒暴露与患痴呆症的风险较高相关。关于出生季节、指长比、产前流感大流行暴露、父母年龄和出生顺序的研究结果不一致，且受相对较高的偏倚风险影响。
我们的研究结果表明，一些产前因素，尤其是那些与产前环境欠佳相关的因素，与患痴呆症风险增加有关。由于这些关联可能受到父母社会经济地位等因素的混杂影响，因此需要更多研究来探讨产前环境在痴呆症中的潜在因果作用。
