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母亲体重指数与儿童脑瘫:系统评价和剂量反应荟萃分析。

Maternal body mass index and cerebral palsy in children: A systematic review and dose-response meta-analysis.

机构信息

The Second Department of pediatrics, The First People's Hospital of Nanyang City, Nanyang, Henan, People's Republic of China.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.

出版信息

Paediatr Perinat Epidemiol. 2024 May;38(4):345-356. doi: 10.1111/ppe.13033. Epub 2023 Dec 26.

Abstract

BACKGROUND

Accumulating studies indicate that maternal obesity is associated with the risk of cerebral palsy (CP); however, their conclusions have been inconsistent.

OBJECTIVES

To quantitatively estimate the association between maternal body mass index (BMI) and CP in offspring.

DATA SOURCES

PubMed, Embase and Web of Science.

STUDY SELECTION AND DATA EXTRACTION

Articles published up to 18 September 2022 were searched that reported the correlation between maternal BMI and CP in children. Two reviewers independently extracted data and critically assessed articles.

SYNTHESIS

Pooled relative risks (RR) and 95% confidence intervals (CI) were estimated by the random-effects model. Subgroup analysis and meta-regression were performed to explore sources of heterogeneity.

RESULTS

In total, 11 articles (8,407,668 participants) were identified for inclusion in our meta-analysis. For maternal underweight, no significant association was found with CP risk (RR 1.11, 95% CI 0.90, 1.38). The risk of CP was increased by 25% (RR 1.25, 95% CI 1.06, 1.47), 38% (RR 1.38, 95% CI 1.18, 1.61) and 127% (RR 2.27, 95% CI 1.82, 2.83) for maternal overweight, obesity and obesity grade 3, respectively. In addition, we observed a positive linear dose-response relationship, with the pooled risk of cerebral palsy in offspring increasing by 3% with each unit increase in maternal BMI.

CONCLUSION

This meta-analysis indicates that the risk of CP in offspring grew with maternal overweight or obesity grades increasing, and was positively correlated with maternal BMI.

摘要

背景

越来越多的研究表明,母体肥胖与脑瘫(CP)的风险相关;然而,他们的结论并不一致。

目的

定量评估母体体重指数(BMI)与后代 CP 的关系。

数据来源

PubMed、Embase 和 Web of Science。

研究选择和数据提取

检索截至 2022 年 9 月 18 日发表的文章,报告了母亲 BMI 与儿童 CP 之间的相关性。两名评审员独立提取数据并对文章进行严格评估。

综合

使用随机效应模型估计合并的相对风险(RR)和 95%置信区间(CI)。进行亚组分析和 meta 回归以探索异质性的来源。

结果

共纳入 11 篇文章(8407668 名参与者)进行荟萃分析。对于母亲体重不足,与 CP 风险无显著关联(RR 1.11,95%CI 0.90,1.38)。CP 的风险增加了 25%(RR 1.25,95%CI 1.06,1.47)、38%(RR 1.38,95%CI 1.18,1.61)和 127%(RR 2.27,95%CI 1.82,2.83),分别为母亲超重、肥胖和肥胖 3 级。此外,我们观察到了阳性线性剂量反应关系,随着母亲 BMI 每增加一个单位,后代脑瘫的合并风险增加 3%。

结论

本荟萃分析表明,随着母亲超重或肥胖程度的增加,后代 CP 的风险增加,并且与母亲 BMI 呈正相关。

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