Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan.
Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
BMJ Open. 2024 Aug 3;14(8):e082585. doi: 10.1136/bmjopen-2023-082585.
To investigate the association between multimorbidity during pregnancy and neurodevelopmental delay in offspring using data from a Japanese nationwide birth cohort study.
This study was a prospective birth cohort study.
This study population included 104 059 fetal records who participated in The Japan Environment and Children's Study from 2011 to 2014.
Pregnant women whose children had undergone developmental testing were included in this analysis.
Neurodevelopment of offspring was assessed using the Japanese version of the Ages and Stages Questionnaire, third edition, comprising five developmental domains. The number of comorbidities among the pregnant women was categorised as zero, single disease or multimorbidity (two or more diseases). Maternal chronic conditions included in multimorbidity were defined as conditions with high prevalence among women of reproductive age. A multivariate logistic regression analysis was conducted to examine the association between multimorbidity in pregnant women and offspring development.
Pregnant women with multimorbidity, single disease and no disease accounted for 3.6%, 30.6% and 65.8%, respectively. The ORs for neurodevelopmental impairment during the follow-up period were similar for infants of mothers with no disease comorbidity and those with a single disease comorbidity. However, the ORs for neurodevelopmental impairment were significantly higher for children born to mothers with multimorbidity compared with those born to healthy mothers.
An association was observed between the number of comorbidities in pregnant women and developmental delay in offspring. Multimorbidity in pregnant women may be associated with neurodevelopmental delay in their offspring. Further research is required in this regard in many other regions of the world.
利用日本全国性出生队列研究的数据，探讨孕妇合并症与后代神经发育迟缓的关系。
本研究为前瞻性出生队列研究。
本研究人群包括参加 2011 年至 2014 年日本环境与儿童研究的 104059 例胎儿记录。
纳入本分析的孕妇为其子女接受发育测试的孕妇。
采用日本版年龄与阶段问卷（第三版）评估后代的神经发育情况，该问卷包含五个发育领域。将孕妇的合并症数量分为零、单病或多合并症（两种或两种以上疾病）。多合并症中包含的母体慢性疾病被定义为育龄妇女中高发的疾病。采用多变量逻辑回归分析来检查孕妇多合并症与后代发育之间的关系。
患有多合并症、单病和无病的孕妇分别占 3.6%、30.6%和 65.8%。在随访期间，无疾病合并症的孕妇和单疾病合并症的孕妇所生婴儿的神经发育障碍的 OR 相似。然而，与健康母亲所生的婴儿相比，多疾病母亲所生的婴儿神经发育障碍的 OR 显著更高。
孕妇合并症的数量与后代发育迟缓之间存在关联。孕妇的多合并症可能与后代的神经发育迟缓有关。在世界其他许多地区，需要进一步开展这方面的研究。
