妊娠期母亲糖尿病与后代患自闭症谱系障碍的风险：一项系统综述和荟萃分析。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-02-01 DOI:10.1016/j.jpsychires.2025.01.003

Mayra J. Garza-Martínez , José Á. Hernández-Mariano , Erika M. Hurtado-Salgado , Lea A. Cupul-Uicab

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引用次数: 0

摘要

导言：子宫内妊娠前糖尿病（2型糖尿病和1型糖尿病）和妊娠糖尿病（GDM）是否是导致自闭症等神经发育改变的因素尚不清楚。因此，我们总结了评估这种关联的研究证据：根据系统综述和荟萃分析首选报告项目（PRISMA）指南，我们进行了一项系统综述和荟萃分析；截至 2023 年 4 月 3 日，我们在 PubMed、Web of Science 和 EBSCO 中找到了符合条件的研究。我们通过随机效应荟萃分析估算了每种母婴糖尿病类型的自闭症汇总OR值。结果：共选取了26篇文献（18篇队列研究和8篇病例对照研究），其中17篇具有荟萃分析数据。我们观察到，与未暴露于T2D（汇总OR=1.48；95%CI：1.31，1.68；n=3,141,255）、T1D（汇总OR=1.73；95%CI：1.05，2.87；n=2,791,607）和GDM（汇总OR=1.31；95%CI：1.16，1.47；n=3,259,557）的人群相比，子宫内暴露于T2D的后代患自闭症的风险增加。T2D没有异质性证据（I2=0.0%），而T1D的异质性很大（I2=64.7%），GDM的异质性中等（I2=53.1%）。宫内暴露于 GDM 的证据更充分，其次是 T2D 和 T1D：我们的研究结果支持这样的假设，即在子宫内暴露于母亲的 T2D 或 GDM 会适度增加后代日后患自闭症的风险。为了更好地估计母体糖尿病对自闭症风险的影响程度，仍需进行前瞻性研究。

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Maternal diabetes during pregnancy and offspring's risk of autism spectrum disorder: A systematic review and meta-analysis

Introduction

Whether in utero exposure to pregestational (type 2 [T2D] and type 1 diabetes [T1D]) and gestational diabetes (GDM) are contributing factors in the rise of neurodevelopmental alterations such as autism is yet unclear. Therefore, we summarized the evidence from studies that assessed such association.

Methods

A systematic review with meta-analyses was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines; eligible studies were identified in PubMed, Web of Science, and EBSCO up to April 3rd, 2023. We estimated pooled OR of autism from random effects meta-analyses for each type of maternal diabetes.

Results

26 publications were selected (18 cohorts and 8 case-controls); 17 had data for the meta-analysis. We observed an increased risk of autism in the offspring exposed in utero to T2D (pooled OR = 1.48; 95%CI: 1.31, 1.68; n = 3,141,255), T1D (pooled OR = 1.73; 95%CI: 1.05, 2.87; n = 2,791,607), and GDM (pooled OR = 1.31; 95% CI: 1.16, 1.47; n = 3,259,557) compared to those unexposed. No evidence of heterogeneity (I² = 0.0%) was observed for T2D, whereas for T1D the heterogeneity was substantial (I² = 64.7%) and for GDM was moderate (I² = 53.1%). The evidence was stronger for in utero exposure to GDM, followed by T2D and T1D.

Conclusions

Our results support the hypothesis that in utero exposure to maternal T2D or GDM moderately increased the offspring's risk of developing autism later in life. Prospectively conducted studies are still warranted to better estimate the size of the effect of maternal diabetes on autism risk.

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;