Department of Child Health Care, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200062, Shanghai, China; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Cognitive Neuroscience, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands.
Department of Child Health Care, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200062, Shanghai, China.
Neurosci Biobehav Rev. 2023 Oct;153:105360. doi: 10.1016/j.neubiorev.2023.105360. Epub 2023 Aug 12.
Abnormal gestational weight gain (GWG) has been increasing globally, up to 47% of all pregnancies. Multiple studies have focused on the association between GWG and adverse neurodevelopmental outcomes in the offspring, however with inconsistent results. We performed a systematic review and meta-analysis to evaluate associations between excessive or insufficient GWG and offspring's neurodevelopmental outcomes. Meta-analysis of these 23 studies using a random-effects model revealed associations between excessive GWG and neurodevelopmental disorders (ASD & ID & ADHD together: OR=1.12 [95% CI 1.06-1.19]), ASD (OR=1.18 [95% CI 1.08-1.29]), ADHD (OR=1.08 [95% CI 1.02-1.14]), ASD with ID (OR=1.15 [95% CI 1.01-1.32]), and ASD without ID (OR=1.12 [95% CI 1.06-1.19]). Insufficient GWG was associated with higher risk for ID (OR=1.14 [95% CI 1.03-1.26]). These results emphasize the significant impact, though of small effect size, of GWG across multiple neurodevelopmental disorders. It is important to note that these results do not establish causality. Other factors such as genetic factors, gene-environment interactions may confound the relationship between GWG and neurodevelopmental outcomes. To better understand the role of GWG in neurodevelopmental disorders, future studies should consider using genetically sensitive designs that can account for these potential confounders.
异常妊娠体重增加（GWG）在全球范围内呈上升趋势，高达 47%的妊娠属于异常。多项研究集中在 GWG 与后代不良神经发育结局之间的关系，但结果不一致。我们进行了系统评价和荟萃分析，以评估 GWG 过多或过少与后代神经发育结局之间的关联。对这 23 项研究进行荟萃分析，采用随机效应模型，结果显示 GWG 过多与神经发育障碍（ASD 和 ID 和 ADHD 总和：OR=1.12[95%CI1.06-1.19]）、ASD（OR=1.18[95%CI1.08-1.29]）、ADHD（OR=1.08[95%CI1.02-1.14]）、ASD 合并 ID（OR=1.15[95%CI1.01-1.32]）和 ASD 无 ID（OR=1.12[95%CI1.06-1.19]）相关，GWG 不足与 ID 风险增加相关（OR=1.14[95%CI1.03-1.26]）。这些结果强调了 GWG 在多种神经发育障碍中的显著影响，尽管影响较小。需要注意的是，这些结果并不能确定因果关系。其他因素，如遗传因素、基因-环境相互作用，可能会混淆 GWG 与神经发育结局之间的关系。为了更好地理解 GWG 在神经发育障碍中的作用，未来的研究应该考虑使用能够解释这些潜在混杂因素的具有遗传敏感性的设计。
