Maternal Pre-pregnancy Body Mass Index and Gestational Weight Gain in Relation to Autism Spectrum Disorder and other Developmental Disorders in Offspring.
Maternal Pre-pregnancy Body Mass Index and Gestational Weight Gain in Relation to Autism Spectrum Disorder and other Developmental Disorders in Offspring.
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DOI：
10.1002/aur.2057
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发表时间：
2019-03
期刊：
影响因子：
--
通讯作者：
Schieve LA
中科院分区：
文献类型：
--
作者：
Windham GC;Anderson M;Lyall K;Daniels JL;Kral TVE;Croen LA;Levy SE;Bradley CB;Cordero C;Young L;Schieve LA
大多数先前的研究检查了母亲怀孕前体重指数（BMI）与后代自闭症谱系障碍（ASD）的关系，但结果并不一致，很少有人还检查了妊娠期体重增加（GWG）。因此，我们在探索早期发展的研究中对两者进行了研究，这是一项针对2003-2006年出生的儿童的多中心病例对照研究。从诊所，学校和出生证明中识别的儿童在2-5岁时登记，并使用标准化发育评估，分类为：ASD，其他发育迟缓（DD）或基于人群的对照。母亲的身高，体重和GWG在电话采访中自我报告。研究了三个主要的体重风险因素：（a）孕前BMI，分类为体重不足至肥胖，（B）GWG连续和分类为五分位数，（c）医学研究所临床体重增加建议。计算足月单胎婴儿的社会人口学和产前因素校正比值比（AOR），将ASD（n = 540）或DD（n = 720）组与对照组（n = 776）进行比较。ASD与母亲肥胖的AOR为1.37（95%CI 0.98-1.92）。与更高GWG的关联更强（Quintile 5 vs. Quintile 3 AOR = 1.58，95%CI 1.08-2.31），尤其是在超重/肥胖女性中（AOR = 1.90，95%CI 0.98-3.68）。DD与母亲超重和肥胖相关（肥胖AOR = 1.48，95%CI 1.08-2.02），但与总GWG或临床建议无关。高母亲BMI和GWG是其他妊娠和儿童结局的危险因素，我们的研究结果表明，它们也可能代表神经发育结局的可改变的危险因素。在一项大型的全国性研究中，我们发现自闭症儿童比未受影响的儿童更有可能在怀孕期间拥有更高体重增加的母亲;如果母亲在怀孕前也超重，自闭症的风险可能会更高。患有其他发育迟缓的儿童更有可能有怀孕前超重或肥胖的母亲，而不是怀孕期间体重增加更多的母亲。超重和体重增加可能代表可以修改的因素。
Most prior studies examining maternal pre-pregnancy body mass index (BMI) in relation to offspring autism spectrum disorders (ASD) have reported an association, though findings are not uniform and few have also examined gestational weight gain (GWG). Therefore, we examined both in the Study to Explore Early Development, a multi-site case–control study of children born in 2003–2006. Children identified from clinics, schools, and birth certificates were enrolled at ages 2–5 year and using standardized developmental evaluations, classified as: ASD, other developmental delays (DD), or population-based controls. Maternal height, weight, and GWG were self-reported during the telephone interview. Three primary weight risk factors were examined: (a) Pre-pregnancy BMI, classified as underweight to obese, (b) GWG continuous and categorized as quintiles, and (c) Institute of Medicine clinical weight-gain recommendations. Odds ratios adjusted (AOR) for sociodemographic and prenatal factors were calculated among term singletons, comparing the ASD (n = 540) or DD (n = 720) groups to the control group (n = 776). The AOR of ASD and maternal obesity was 1.37 (95%CI 0.98–1.92). Associations with higher GWG were stronger (Quintile5 vs. Quintile3 AOR = 1.58, 95%CI 1.08–2.31), and particularly so among overweight/obese women (AOR = 1.90, 95%CI 0.98–3.68). DD was associated with maternal overweight and obesity (obesity AOR = 1.48, 95%CI 1.08–2.02), but not with total GWG or clinical recommendations. High maternal BMI and GWG are risk factors for other pregnancy and child outcomes, and our results suggest they may also represent modifiable risk factors for neurodevelopmental outcomes. In a large, national study, we found that children with autism were more likely than unaffected children to have mothers with higher weight gain during pregnancy; risk of autism may be even stronger if mothers were also overweight before pregnancy. Children with other developmental delays were more likely to have mothers who were overweight or obese before pregnancy, but not who gained more weight during pregnancy. Overweight and weight gain may represent factors that could be modified.
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发表时间：
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影响因子：
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