Chang Ya-Hui, Chien Yu-Wen, Chang Chiung-Hsin, Chen Ping-Ling, Lu Tsung-Hsueh, Yen Cheng-Fang, Chiou Hung-Yi, Tsai Kuo-Sheng, Li Chung-Yi
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Emergency Department, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.
Pediatr Res. 2024 Sep 30. doi: 10.1038/s41390-024-03608-3.
To evaluate the association between maternal MVCs during pregnancy and neurodevelopmental disorders (NDDs, including intellectual disability, ADHD, ASD, and infantile cerebral palsy) in children.
This population-based cohort of live births in Taiwan was analyzed, comparing children born to mothers involved in MVCs during pregnancy with those without such exposure. Children were linked to the insurance database to identify the possible diagnosis of NDDs. The Cox proportional hazards regression model was used to estimate the relative hazards.
A total of 19,277 children with maternal MVCs and 76,015 children without exposure were included. Children exposed to maternal MVCs during the first two trimesters or whose mothers sustained mild to severe injuries showed a higher risk of intellectual disability. Severe maternal injuries also increased the risk of infantile cerebral palsy (aHR = 3.86; 1.27-11.78). MVCs in the third trimester, or mild maternal injuries, were associated with a higher risk of ASD (third trimester: aHR = 1.40; 1.04-1.87; mild injuries: aHR = 1.38; 1.09-1.74).
Children exposed to maternal MVCs with severe injuries had a higher risk of intellectual disability and cerebral palsy. Third-trimester exposure may increase the risk of ASD. However, these findings should be interpreted cautiously as genetic factors may contribute to the observed association.
There is some evidence linking maternal MVCs during pregnancy to the development of neurodevelopmental disorders in children. Children of mothers with severely injured were more likely to suffer from infantile cerebral palsy and intellectual disability. The risk of autism spectrum disorder is higher in children whose mothers are involved in MVCs during the late stage of pregnancy, and there is also an increased risk of intellectual disability during the first two trimesters.
评估孕期母亲机动车碰撞事故（MVCs）与儿童神经发育障碍（NDDs，包括智力残疾、注意力缺陷多动障碍、自闭症谱系障碍和小儿脑瘫）之间的关联。
对台湾地区基于人群的活产队列进行分析，比较孕期发生MVCs的母亲所生儿童与未暴露于此类情况的母亲所生儿童。将儿童与保险数据库关联以确定可能的NDDs诊断。采用Cox比例风险回归模型估计相对风险。
共纳入19277名母亲发生MVCs的儿童和76015名未暴露儿童。孕早期和孕中期暴露于母亲MVCs或其母亲遭受轻度至重度损伤的儿童患智力残疾的风险更高。母亲严重受伤也增加了小儿脑瘫的风险（调整后风险比[aHR]=3.86；1.27 - 11.78）。孕晚期的MVCs或母亲轻度受伤与自闭症谱系障碍风险较高相关（孕晚期：aHR = 1.40；1.04 - 1.87；轻度损伤：aHR = 1.38；1.09 - 1.74）。
暴露于母亲严重受伤的MVCs的儿童患智力残疾和脑瘫的风险更高。孕晚期暴露可能增加自闭症谱系障碍的风险。然而，由于遗传因素可能导致观察到的关联，这些发现应谨慎解释。
有一些证据表明孕期母亲MVCs与儿童神经发育障碍的发生有关。母亲严重受伤的儿童更易患小儿脑瘫和智力残疾。母亲在孕晚期发生MVCs的儿童患自闭症谱系障碍的风险更高，且孕早期和孕中期患智力残疾的风险也增加。
