Department of Preventive Medicine, University of Southern California, Los Angeles, USA.
Department of Maternal and Fetal Medicine, Keck School of Medicine, Los Angeles, USA.
Pregnancy Hypertens. 2023 Sep;33:22-29. doi: 10.1016/j.preghy.2023.06.002. Epub 2023 Jun 23.
To synthesize epidemiologic literature pertaining to the association between preeclampsia (PE), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and epilepsy.
A systematic search of PubMed and Embase was performed supplemented by hand-searching of reference lists of eligible studies. Two independent reviewers screened abstracts following a prepared protocol. Data extraction and quality appraisal using the Newcastle Ottawa Scale were performed by an independent reviewer. PRISMA guidelines were followed throughout. Random-effects meta-analyses were performed. Adjusted pooled Odds Ratios and their 95% confidence intervals were reported.
Fifteen out of 121 identified studies were eligible for inclusion. Six reported adjusted estimates for ADHD, resulting in a pooled odds ratio of 1.29 (95% CI: 1.20, 1.38). Eight reported adjusted estimates for ASD, resulting in a pooled odds ratio of 1.27 (95% CI:1.22, 1.32). Three reported adjusted estimates for epilepsy, resulting in a pooled odds ratio of 1.35 (95% CI: 1.12, 1.63).
Intrauterine exposure to PE increased the risk of ADHD, ASD, and epilepsy, though it is unclear whether the true association is with pre-term birth. To our knowledge, this is the first meta-analysis to quantify the association between PE and epilepsy. The results of this meta-analysis can inform screening strategies among children born to preeclamptic mothers for early identification and treatment.
综合与先兆子痫 (PE)、注意力缺陷多动障碍 (ADHD)、自闭症谱系障碍 (ASD) 和癫痫之间关联的流行病学文献。
对 PubMed 和 Embase 进行了系统搜索，并对合格研究的参考文献进行了手工搜索补充。两名独立审查员根据既定方案筛选摘要。使用纽卡斯尔-渥太华量表进行独立审查员的数据提取和质量评估。整个过程遵循 PRISMA 指南。进行了随机效应荟萃分析。报告了调整后的合并优势比及其 95%置信区间。
在 121 项确定的研究中，有 15 项符合纳入标准。有 6 项研究报告了 ADHD 的调整后估计值，合并优势比为 1.29（95%CI：1.20，1.38）。有 8 项研究报告了 ASD 的调整后估计值，合并优势比为 1.27（95%CI：1.22，1.32）。有 3 项研究报告了癫痫的调整后估计值，合并优势比为 1.35（95%CI：1.12，1.63）。
子宫内暴露于 PE 增加了 ADHD、ASD 和癫痫的风险，但尚不清楚真正的关联是否与早产有关。据我们所知，这是首次定量分析 PE 和癫痫之间关联的荟萃分析。该荟萃分析的结果可以为子痫前期母亲所生儿童的筛查策略提供信息，以便早期发现和治疗。
