Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
Nutrients. 2024 Oct 3;16(19):3366. doi: 10.3390/nu16193366.
The relationship between the intake of artificial sweetener (AS) and adverse pregnancy outcomes is under-researched, and existing studies yield inconsistent conclusions. A Mendelian randomization (MR) approach was employed to investigate the causal relationship between the intake of AS and adverse pregnancy outcomes. Instrumental variables related to the exposure phenotype were selected for analysis. The analysis was conducted using genome-wide association study summary data from public datasets. The inverse variance weighted, MR-Egger, weighted median, simple mode, and weighted mode methods were used to evaluate the causal relationship between exposure and outcomes. Sensitivity analysis and multivariable Mendelian randomization enrolling body mass index, type 2 diabetes mellitus, and fasting glucose were employed to further validate the consistency and robustness of the results. In univariable MR, the intake of AS added to tea was associated with an increased risk of ectopic pregnancy [OR = 1.821 (1.118-2.967), = 0.016]. In multivariable MR adjusting for body mass index and type 2 diabetes mellitus, the intake of AS added to cereal was linked to a reduced risk of ectopic pregnancy [OR = 0.361 (0.145-0.895), = 0.028] and premature rupture of membranes [OR = 0.116 (0.019-0.704), = 0.019], while the intake of artificial sweetener added to coffee was associated with an increased risk of placenta previa [OR = 1.617 (1.042-2.510), = 0.032]. No causal relationship was identified between the intake of artificial sweetener and other adverse pregnancy outcomes. The consumption of artificial sweetener during pregnancy warrants careful consideration.
人工甜味剂（AS）的摄入与不良妊娠结局之间的关系尚未得到充分研究，现有研究得出的结论也不一致。本研究采用孟德尔随机化（MR）方法来研究 AS 的摄入与不良妊娠结局之间的因果关系。选择与暴露表型相关的工具变量进行分析。使用来自公共数据集的全基因组关联研究汇总数据进行分析。采用逆方差加权、MR-Egger、加权中位数、简单模式和加权模式方法来评估暴露与结局之间的因果关系。采用敏感性分析和多变量孟德尔随机化纳入体重指数、2 型糖尿病和空腹血糖，进一步验证结果的一致性和稳健性。在单变量 MR 中，添加到茶中的 AS 摄入与异位妊娠的风险增加相关[比值比（OR）=1.821（1.118-2.967）， = 0.016]。在多变量 MR 中，调整体重指数和 2 型糖尿病后，添加到谷物中的 AS 摄入与异位妊娠的风险降低相关[OR = 0.361（0.145-0.895）， = 0.028]和胎膜早破[OR = 0.116（0.019-0.704）， = 0.019]，而添加到咖啡中的 AS 摄入与前置胎盘的风险增加相关[OR = 1.617（1.042-2.510）， = 0.032]。AS 的摄入与其他不良妊娠结局之间没有发现因果关系。在怀孕期间摄入人工甜味剂需要谨慎考虑。
