[母亲妊娠期糖尿病与后代患自闭症谱系障碍风险之间的关联]
[Association between maternal gestational diabetes mellitus and the risk of autism spectrum disorder in offspring].
作者信息
Liu Xian, Guo Cheng, Zou Ming-Yang, Feng Fang-Mei, Liang Si-Min, Chen Wen-Xiong, Wu Li-Jie
机构信息
Department of Maternal and Child Health, School of Public Health, Harbin Medical University, Harbin 150001, China.
Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University/Guangdong Provincial Clinical Research Center for Child Health, Guangzhou 510623, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2023 Aug 15;25(8):818-823. doi: 10.7499/j.issn.1008-8830.2301021.
OBJECTIVES
To explore the association between maternal gestational diabetes mellitus (GDM) exposure and the development of autism spectrum disorder (ASD) in offspring.
METHODS
A case-control study was conducted, recruiting 221 children with ASD and 400 healthy children as controls. Questionnaires and interviews were used to collect information on general characteristics of the children, socio-economic characteristics of the family, maternal pregnancy history, and maternal disease exposure during pregnancy. Multivariate logistic regression analysis was used to investigate the association between maternal GDM exposure and the development of ASD in offspring. The potential interaction between offspring gender and maternal GDM exposure on the development of ASD in offspring was explored.
RESULTS
The proportion of maternal GDM was significantly higher in the ASD group compared to the control group (16.3% vs 9.4%, =0.014). After adjusting for variables such as gender, gestational age, mode of delivery, parity, and maternal education level, maternal GDM exposure was a risk factor for ASD in offspring (=2.18, 95%: 1.04-4.54, =0.038). On the basis of adjusting the above variables, after further adjusting the variables including prenatal intake of multivitamins, folic acid intake in the first three months of pregnancy, and assisted reproduction the result trend did not change, but no statistical significance was observed (=1.94, 95%: 0.74-5.11, =0.183). There was an interaction between maternal GDM exposure and offspring gender on the development of ASD in offspring (<0.001). Gender stratified analysis showed that only in male offspring of mothers with GDM, the risk of ASD was significantly increased (=3.67, 95%: 1.16-11.65, =0.027).
CONCLUSIONS
Maternal GDM exposure might increase the risk of ASD in offspring. There is an interaction between GDM exposure and offspring gender in the development of ASD in offspring.
目的
探讨母亲孕期糖尿病（GDM）暴露与子代自闭症谱系障碍（ASD）发生之间的关联。
方法
开展一项病例对照研究，招募221例患有ASD的儿童和400例健康儿童作为对照。通过问卷调查和访谈收集儿童的一般特征、家庭社会经济特征、母亲妊娠史以及母亲孕期疾病暴露情况等信息。采用多因素逻辑回归分析来研究母亲GDM暴露与子代ASD发生之间的关联。探讨子代性别与母亲GDM暴露对子代ASD发生的潜在交互作用。
结果
与对照组相比，ASD组母亲患GDM的比例显著更高（16.3%对9.4%，P=0.014）。在调整性别、孕周、分娩方式、产次和母亲教育水平等变量后，母亲GDM暴露是子代患ASD的一个危险因素（P=2.18，95%置信区间：1.04 - 4.54，P=0.038）。在调整上述变量的基础上，进一步调整包括孕期服用多种维生素、孕早期叶酸摄入以及辅助生殖等变量后，结果趋势未改变，但未观察到统计学意义（P=1.94，95%置信区间：0.74 - 5.11，P=0.183）。母亲GDM暴露与子代性别在子代ASD发生上存在交互作用（P<0.001）。性别分层分析显示，仅在母亲患有GDM的男性子代中，患ASD的风险显著增加（P=3.67，95%置信区间：1.16 - 11.65，P=0.027）。
结论
母亲GDM暴露可能增加子代患ASD的风险。在子代ASD发生过程中，GDM暴露与子代性别之间存在交互作用。
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