Association of maternal diabetes with neurodevelopmental disorders: autism spectrum disorders, attention-deficit/hyperactivity disorder and intellectual disability.
Association of maternal diabetes with neurodevelopmental disorders: autism spectrum disorders, attention-deficit/hyperactivity disorder and intellectual disability.
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母体糖尿病与神经发育障碍的关联：自闭症谱系障碍，注意力缺陷/多动障碍和智力障碍。
DOI：
10.1093/ije/dyaa212
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发表时间：
2021-05-17
影响因子：
7.7
通讯作者：
Gardner R
中科院分区：
文献类型：
--
作者：
Chen S;Zhao S;Dalman C;Karlsson H;Gardner R
母体糖尿病与后代神经发育障碍（NDD）的风险相关，尽管自闭症谱系障碍（ASD），注意力缺陷/多动障碍（ADHD）和智力残疾（ID）的常见并发症很少被考虑，也没有被共同的家族因素（例如遗传学）混淆的可能性。这项基于人群的队列研究使用了瑞典精神病学的数据，这是瑞典国家登记的一个链接，跟踪了1987年至2010年出生的2369680人。我们使用人群平均logit模型来研究母体1型糖尿病（T1 DM）、妊娠前2型糖尿病（T2 DM）或妊娠期糖尿病（GDM）暴露与后代NDD几率之间的相关性。然后进行亚组分析，以调查妊娠期GDM诊断的时间及其对后代NDD几率的影响。我们将这些结果与考虑父亲终生T1 DM和T2 DM暴露的模型进行了比较。总的来说，45678人（1.93%）被诊断为ASD，20823人（0.88%）被诊断为ID，102018人（4.31%）被诊断为ADHD。所有类型的母亲糖尿病都与NDD的几率相关，T2 DM与ASD（调整的比值比为1.37，95%置信区间为1.03-1.84）、ID（2.09，1.53-2.87）和ADHD（1.43，1.16-1.77）的任何诊断密切相关。考虑到常见的共病组，母亲糖尿病和诊断组合之间的关联最强，包括ID。父亲T1 DM和T2 DM诊断也与后代NDD相关，但这些关联弱于母亲糖尿病。妊娠27至30周之间的GDM诊断通常与后代NDD的最大风险相关，与包括ID在内的结局相关性最强。母体糖尿病与后代NDD的相关性取决于NDD的共病表现，与包括ID在内的结果相关的几率最大。比较研究表明，上述关联可能会部分被共同的家族因素（例如遗传易感性）所混淆。
Maternal diabetes has been associated with a risk of neurodevelopmental disorders (NDDs) in offspring, though the common co-occurrence of autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) and intellectual disability (ID) is rarely considered, nor is the potential for confounding by shared familial factors (e.g. genetics). This population-based cohort study used data from Psychiatry Sweden, a linkage of Swedish national registers, to follow 2 369 680 individuals born from 1987 to 2010. We used population-averaged logit models to examine the association between exposure to maternal type 1 diabetes mellitus (T1DM), pre-gestational type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM), and odds of NDDs in offspring. Subgroup analysis was then performed to investigate the timings of GDM diagnosis during pregnancy and its effect on the odds of NDDs in offspring. We compared these results to models considering paternal lifetime T1DM and T2DM as exposures. Overall, 45 678 individuals (1.93%) were diagnosed with ASD, 20 823 (0.88%) with ID and 102 018 (4.31%) with ADHD. All types of maternal diabetes were associated with odds of NDDs, with T2DM most strongly associated with any diagnosis of ASD (odds ratioadjusted 1.37, 95% confidence interval 1.03–1.84), ID (2.09, 1.53–2.87) and ADHD (1.43, 1.16–1.77). Considering common co-morbid groups, the associations were strongest between maternal diabetes and diagnostic combinations that included ID. Paternal T1DM and T2DM diagnoses were also associated with offspring NDDs, but these associations were weaker than those with maternal diabetes. Diagnosis of GDM between 27 and 30 weeks of gestation was generally associated with the greatest risk of NDDs in offspring, with the strongest associations for outcomes that included ID. The association of maternal diabetes with NDDs in offspring varies depending on the co-morbid presentation of the NDDs, with the greatest odds associated with outcomes that included ID. Results of paternal-comparison studies suggest that the above associations are likely to be partly confounded by shared familial factors, such as genetic liability.
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