Intrapartum exposure to synthetic oxytocin, maternal BMI, and neurodevelopmental outcomes in children within the ECHO consortium

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurodevelopmental Disorders Pub Date : 2024-05-26 DOI:10.1186/s11689-024-09540-1

Lisa Kurth, T. Michael O’Shea, Irina Burd, Anne L. Dunlop, Lisa Croen, Greta Wilkening, Ting-ju Hsu, Stephan Ehrhardt, Arvind Palanisamy, Monica McGrath, Marie L. Churchill, Daniel Weinberger, Marco Grados, Dana Dabelea

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Abstract

Synthetic oxytocin (sOT) is frequently administered during parturition. Studies have raised concerns that fetal exposure to sOT may be associated with altered brain development and risk of neurodevelopmental disorders. In a large and diverse sample of children with data about intrapartum sOT exposure and subsequent diagnoses of two prevalent neurodevelopmental disorders, i.e., attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), we tested the following hypotheses: (1) Intrapartum sOT exposure is associated with increased odds of child ADHD or ASD; (2) associations differ across sex; (3) associations between intrapartum sOT exposure and ADHD or ASD are accentuated in offspring of mothers with pre-pregnancy obesity. The study sample comprised 12,503 participants from 44 cohort sites included in the Environmental Influences on Child Health Outcomes (ECHO) consortium. Mixed-effects logistic regression analyses were used to estimate the association between intrapartum sOT exposure and offspring ADHD or ASD (in separate models). Maternal obesity (pre-pregnancy BMI ≥ 30 kg/m2) and child sex were evaluated for effect modification. Intrapartum sOT exposure was present in 48% of participants. sOT exposure was not associated with increased odds of ASD (adjusted odds ratio [aOR] 0.86; 95% confidence interval [CI], 0.71–1.03) or ADHD (aOR 0.89; 95% CI, 0.76–1.04). Associations did not differ by child sex. Among mothers with pre-pregnancy obesity, sOT exposure was associated with lower odds of offspring ADHD (aOR 0.72; 95% CI, 0.55–0.96). No association was found among mothers without obesity (aOR 0.97; 95% CI, 0.80–1.18). In a large, diverse sample, we found no evidence of an association between intrapartum exposure to sOT and odds of ADHD or ASD in either male or female offspring. Contrary to our hypothesis, among mothers with pre-pregnancy obesity, sOT exposure was associated with lower odds of child ADHD diagnosis.

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产前接触合成催产素、孕产妇体重指数和 ECHO 联合体中儿童的神经发育结果

合成催产素（sOT）经常在分娩过程中使用。有研究担心，胎儿接触 sOT 可能与大脑发育改变和神经发育障碍风险有关。在一个大型、多样化的儿童样本中，我们获得了有关产前暴露于 sOT 以及随后诊断出两种普遍存在的神经发育障碍（即：注意力缺陷多动障碍（AD））的数据、我们测试了以下假设：（1）产前暴露于 sOT 与儿童多动症或自闭症的几率增加有关；（2）不同性别之间的相关性不同；（3）母亲孕前肥胖的后代在产前暴露于 sOT 与多动症或自闭症之间的相关性更强。研究样本包括环境对儿童健康结果的影响（ECHO）联盟中 44 个队列研究点的 12,503 名参与者。研究采用混合效应逻辑回归分析来估算产前 sOT 暴露与后代多动症或 ASD 之间的关系（在不同的模型中）。对母亲肥胖（孕前体重指数≥ 30 kg/m2）和儿童性别进行了效应修正评估。48%的参与者在产前暴露于sOT。sOT暴露与ASD（调整后几率比[aOR]为0.86；95%置信区间[CI]为0.71-1.03）或ADHD（aOR为0.89；95%置信区间[CI]为0.76-1.04）的几率增加无关。儿童性别不同，相关性也不同。在孕前肥胖的母亲中，接触 sOT 可降低后代患多动症的几率（aOR 0.72；95% CI，0.55-0.96）。在没有肥胖症的母亲中没有发现相关性（aOR 0.97；95% CI，0.80-1.18）。在一个大型、多样化的样本中，我们没有发现产前暴露于 sOT 与男性或女性后代患多动症或 ASD 的几率之间存在关联的证据。与我们的假设相反，在孕前肥胖的母亲中，sOT 暴露与较低的儿童多动症诊断几率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurodevelopmental Disorders 医学-临床神经学

CiteScore

7.60

自引率

4.10%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Neurodevelopmental Disorders is an open access journal that integrates current, cutting-edge research across a number of disciplines, including neurobiology, genetics, cognitive neuroscience, psychiatry and psychology. The journal’s primary focus is on the pathogenesis of neurodevelopmental disorders including autism, fragile X syndrome, tuberous sclerosis, Turner Syndrome, 22q Deletion Syndrome, Prader-Willi and Angelman Syndrome, Williams syndrome, lysosomal storage diseases, dyslexia, specific language impairment and fetal alcohol syndrome. With the discovery of specific genes underlying neurodevelopmental syndromes, the emergence of powerful tools for studying neural circuitry, and the development of new approaches for exploring molecular mechanisms, interdisciplinary research on the pathogenesis of neurodevelopmental disorders is now increasingly common. Journal of Neurodevelopmental Disorders provides a unique venue for researchers interested in comparing and contrasting mechanisms and characteristics related to the pathogenesis of the full range of neurodevelopmental disorders, sharpening our understanding of the etiology and relevant phenotypes of each condition.