Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China.
Ital J Pediatr. 2023 Oct 15;49(1):139. doi: 10.1186/s13052-023-01532-6.
Maternal diabetes might be related to a high risk of allergic disease in offspring. However, it remains unknown if maternal gestational diabetes mellitus (GDM) is also associated with a high incidence of childhood asthma in offspring. A systematic review and meta-analysis was performed to investigate the above association.
Relevant observational studies were obtained by search of electronic databases including Medline, Embase, Cochrane Library, and Web of Science. A randomized-effects model was selected to pool the data by incorporating the influence of potential heterogeneity. The Newcastle-Ottawa Scale was used for study quality evaluation. Subgroup analyses were performed to evaluate the potential influences of study characteristics on the outcome.
Ten datasets from seven moderate to high quality cohort studies, involving 523,047 mother-child pairs were included in the meta-analysis. Overall, maternal GDM was associated with a higher risk of childhood asthma in offspring (risk ratio [RR]: 1.22, 95% confidence interval [CI]: 1.07 to 1.39, p = 0.003; I = 30%). Subgroup analyses showed that the association was not significantly affected by study design, validation methods for GDM, or diagnostic strategy for asthma (p for subgroup analyses all > 0.05). The association between maternal GDM and asthma in offspring was more remarkable after adjusting maternal body mass index in early pregnancy (RR: 1.50 versus 1.06, p < 0.001), but significantly weakened after adjusting hypertensive disorders during pregnancy (RR: 1.08 versus 1.50, p = 0.001).
Maternal GDM may be associated with an increased incidence of childhood asthma in offspring.
母体糖尿病可能与后代过敏疾病的高风险有关。然而，母体妊娠期糖尿病（GDM）是否也与后代儿童哮喘的高发率有关仍不清楚。进行了系统评价和荟萃分析，以调查上述关联。
通过搜索 Medline、Embase、Cochrane 图书馆和 Web of Science 等电子数据库获得相关观察性研究。选择随机效应模型，通过纳入潜在异质性的影响来汇总数据。使用纽卡斯尔-渥太华量表评估研究质量。进行亚组分析，以评估研究特征对结果的潜在影响。
荟萃分析纳入了来自七项中等到高质量队列研究的十个数据集，涉及 523047 对母婴对。总体而言，母体 GDM 与后代儿童哮喘的风险增加相关（风险比 [RR]：1.22，95%置信区间 [CI]：1.07 至 1.39，p=0.003；I=30%）。亚组分析表明，该关联不受研究设计、GDM 的验证方法或哮喘的诊断策略的显著影响（p 对于亚组分析均>0.05）。在校正孕早期母体体重指数后，母体 GDM 与后代哮喘之间的关联更为显著（RR：1.50 与 1.06，p<0.001），但在校正妊娠期高血压疾病后，该关联显著减弱（RR：1.08 与 1.50，p=0.001）。
母体 GDM 可能与后代儿童哮喘的发病率增加有关。
