Department of Pediatrics, Jiujiang Maternal and Child Health Care Hospital in JiangXi Province, China.
Department of Dermatology, Attached Hospital, Jiujiang University, JiangXi Province, China.
Taiwan J Obstet Gynecol. 2024 Jul;63(4):479-485. doi: 10.1016/j.tjog.2024.04.006.
The purpose of this review was to examine if maternal hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) result in an increased risk of atopic dermatitis or eczema (AD-E) in childhood. We searched the databases of PubMed, Embase, CENTRAL, Web of Science, and Scopus for cohort or case-control studies up to 25th June 2023. Random-effects meta-analysis was done to generate the odds ratio (OR) of the association between HDP/GDM and AD-E. Eight studies were included. Meta-analysis of five studies showed that GDM in the mother was associated with an increased risk of AD-E in the offspring (OR: 1.35 95% CI: 1.13, 1.61 I = 61%). Pooled analysis of four studies demonstrated no association between HDP and risk of AD-E in the offspring (OR: 1.03 95% CI: 0.99, 1.08 I = 0%). The results did not change on sensitivity analysis and subgroup analysis based on study type, method of AD-E diagnosis, and sample size. This meta-analysis suggests that GDM may significantly increase the risk of AD-E in childhood, however, HDP does not seem to impact the risk of AD-E. Evidence is limited by the small number of studies and high interstudy heterogeneity. Further studies are needed to improve the quality of evidence.
本次综述的目的在于探讨母亲妊娠高血压疾病(HDP)和妊娠糖尿病(GDM)是否会增加儿童特应性皮炎或湿疹(AD-E)的风险。我们检索了 PubMed、Embase、CENTRAL、Web of Science 和 Scopus 数据库,以获取截至 2023 年 6 月 25 日的队列或病例对照研究。采用随机效应荟萃分析生成 HDP/GDM 与 AD-E 之间关联的比值比(OR)。共纳入 8 项研究。五项研究的荟萃分析表明,母亲的 GDM 与后代患 AD-E 的风险增加相关(OR:1.35,95%CI:1.13,1.61,I²=61%)。四项研究的汇总分析表明,HDP 与后代患 AD-E 的风险之间无关联(OR:1.03,95%CI:0.99,1.08,I²=0%)。敏感性分析和基于研究类型、AD-E 诊断方法和样本量的亚组分析结果不变。这项荟萃分析表明,GDM 可能会显著增加儿童患 AD-E 的风险,但 HDP 似乎不会影响 AD-E 的风险。研究数量较少且存在高度异质性,限制了证据质量。需要进一步的研究来提高证据质量。