Association of Maternal Immune Activation during Pregnancy and Neurologic Outcomes in Offspring
Association of Maternal Immune Activation during Pregnancy and Neurologic Outcomes in Offspring
复制标题
DOI：
10.1016/j.jpeds.2021.04.069
复制
发表时间：
2021-10-23
影响因子：
5.1
通讯作者：
Piao, Xianhua H.
中科院分区：
文献类型：
--
作者：
Jain, Samhita;Baer, Rebecca J.;Piao, Xianhua H.
目的 使用包容性定义，评估后代第一年的神经发病率与产前母体免疫激活 (MIA) 的关系。 研究设计 这项回顾性队列研究包括 2011 年至 2017 年在加利福尼亚州出生的单胎。MIA 的定义是根据国际疾病分类诊断妊娠期间感染、自身免疫性疾病、过敏、哮喘、动脉粥样硬化或恶性肿瘤。婴儿的神经系统发病率是根据国际疾病分类诊断的脑室内出血、脑室周围白质软化、癫痫、神经系统检查异常或神经系统影像异常来定义的。还探讨了生命第一年延迟发育里程碑的结果。使用对数链接二元回归估算患有和不患有 MIA 的女性后代神经系统发病风险。结果 3 004 166 名患有或不患有 MIA 的母婴二人组中的人口统计学特征在两组中相似。患有MIA的母亲的早产率（9.4%）显着高于未患有MIA的母亲（5.6%）。患有 MIA 的母亲所生的婴儿在所有孕龄期间都更有可能出现神经系统疾病。暴露婴儿神经系统检查异常的调整相对风险 (95% CI) 为 2.0 (1.9-2.1)；癫痫发作为 1.6 (1.5-1.7)，脑室周围白质软化为 1.6 (1.4-1.8)。 结论 我们的结果表明，妊娠期间 MIA 可能与后代神经系统发病风险相当高相关。
Objective To evaluate neurologic morbidity among offspring during their first year of life in association with prenatal maternal immune activation (MIA), using an inclusive definition.Study design This retrospective cohort study included singletons born in California between 2011 and 2017. MIA was defined by International Classification of Diseases diagnosis of infection, autoimmune disorder, allergy, asthma, atherosclerosis, or malignancy during pregnancy. Neurologic morbidity in infants was defined by International Classification of Diseases diagnosis of intraventricular hemorrhage, periventricular leukomalacia, seizures, abnormal neurologic examination, or abnormal neurologic imaging. Outcomes of delayed developmental milestones during the first year of life were also explored. Risk of neurologic morbidity in offspring was approximated for women with and without MIA using log link binary regression.Results Demographic characteristics among 3 004 166 mother-infant dyads with or without MIA were similar in both groups. Rate of preterm delivery in mothers with MIA (9.4%) was significantly higher than those without MIA (5.6%). Infants of mothers with MIA were more likely to experience neurologic morbidities across all gestational ages. Adjusted relative risk (95% CI) in the exposed infants was 2.0 (1.9-2.1) for abnormal neurologic examination; 1.6 (1.5-1.7) for seizures, and 1.6 (1.4-1.8) for periventricular leukomalacia.Conclusions Our results demonstrate that MIA during pregnancy may be associated with considerably higher risk of neurologic morbidity in offspring.