后代神经/行为发育异常或与母亲糖尿病相关
创作:Epi汪 审核:Epi汪 2019年07月26日
  • 检索公开数据库,纳入19篇相关的文章,并提取数据,最终纳入18681名糖尿病孕妇和285万余名对照组;
  • 糖尿病组后代儿童智商得分平均低3.07分;
  • 糖尿病组后代儿童患孤独症谱系障碍、注意缺陷/多动障碍的风险增高;
  • 无论是1型还是2型糖尿病,上述主要关联均存在,其他敏感性分析结果均较稳健;
  • 纳入研究的暴露组和对照组之间的可比性以及队列随访的质量不一是本研究的局限性;
  • 胎儿宫内暴露于母亲糖尿病与产后不良认知和行为结果有关联。
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Epi汪
本荟萃分析通过纳入相关的研究数据,发现儿童的神经行为发育异常,包括智商降低、孤独症以及多动症等,与母亲在孕前患有糖尿病是存在关联的。但其中的具体机制有待进一步研究。
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Diabetologia [IF:7.518]

Neurocognitive and behavioural outcomes in offspring exposed to maternal pre-existing diabetes: a systematic review and meta-analysis

母亲孕前糖尿病与后代儿童神经行为结果的关联:一项系统综述和荟萃分析

10.1007/s00125-019-4923-0

2019-07-05, Review

Abstract & Authors:展开

Abstract:收起
AIMS/HYPOTHESIS: We performed a systematic review and meta-analysis to determine whether exposure to maternal pre-existing diabetes in pregnancy is associated with neurocognitive or behavioural outcomes in offspring.
METHODS: We searched MEDLINE, EMBASE, PsychINFO, the Cochrane Database of Systematic Reviews and Scopus for studies that examined any neurocognitive or behavioural outcomes in offspring of mothers with pre-existing diabetes in pregnancy in accordance with a published protocol (PROSPERO CRD42018109038). Title and abstract review, full-text review and data extraction were performed independently and in duplicate. Risk of bias was assessed using the Newcastle-Ottawa scale. Meta-analyses of summary measures were performed using random-effects models.
RESULTS: Nineteen articles including at least 18,681 exposed and 2,856,688 control participants were identified for inclusion. Exposure to maternal pre-existing diabetes in pregnancy was associated with a lower pooled intelligence quotient in the offspring (pooled weighted mean difference -3.07 [95% CI -4.59, -1.55]; I = 0%) and an increased risk of autism spectrum disorders (effect estimate 1.98 [95% CI 1.46, 2.68]; I = 0%). There was also an increased risk of attention deficit/hyperactivity disorder (pooled HR 1.36 [95% CI 1.19, 1.55]; I = 0%), though this was based on only two studies. Although most studies were found to be high quality in terms of participant selection, in many studies, comparability of cohorts and adequacy of follow-up were sources of bias.
CONCLUSIONS/INTERPRETATION: There is evidence to suggest that in utero exposure to maternal pre-existing diabetes is associated with some adverse neurocognitive and behavioural outcomes. It remains unclear what the role of perinatal factors is and the degree to which other environmental factors contribute to these findings.

First Authors:
Jennifer M Yamamoto

Correspondence Authors:
Jennifer M Yamamoto

All Authors:
Jennifer M Yamamoto,Jamie L Benham,Deborah Dewey,J Johanna Sanchez,Helen R Murphy,Denice S Feig,Lois E Donovan

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