Maternal diabetes and hypertensive disorders in association with autism spectrum disorder
Maternal diabetes and hypertensive disorders in association with autism spectrum disorder
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DOI：
10.1002/aur.2105
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发表时间：
2019-06-01
期刊：
影响因子：
4.7
通讯作者：
Daniels, Julie L.
中科院分区：
文献类型：
--
作者：
Cordero, Christina;Windham, Gayle C.;Daniels, Julie L.
以前的研究表明，怀孕并发症，往往是在总体上检查，与自闭症谱系障碍（ASD）有关。具体并发症的结果，如产妇糖尿病和高血压，并没有统一的一致性，应该独立调查有关ASD在一个大的社区为基础的样本。探索早期发育研究（SEED）是一项美国多地点病例对照研究，招募了2003-2006年出生的2-5岁儿童。根据ASD（n = 698）、非ASD发育迟缓（DD; n = 887）或来自普通人群的对照（POP; n = 979）的确认，将儿童分为三组。任何糖尿病或高血压疾病的诊断在怀孕期间确定从产前医疗记录和产妇自我报告。Logistic回归模型估计调整后的比值比（aOR）和置信区间（CI），调整母亲年龄，种族/民族，教育，怀孕期间吸烟和研究中心。高血压模型还根据产次和多胎进行了调整。在2,564名母亲中，我们确定了246名（9.6%）患有糖尿病，386名（15.1%）患有妊娠期高血压。校正协变量后，妊娠期糖尿病与ASD无关（aOR = 1.10 [95% CI 0.77，1.56]），但高血压与ASD相关（aOR = 1.69 [95% CI 1.26，2.26]）。DD和任何糖尿病（aOR = 1.29 [95%CI 0.94，1.78]）或任何高血压（aOR = 1.71 [95%CI 1.30，2.25]）的结果相似。一些妊娠并发症，如高血压，可能在自闭症病因中发挥作用，并可能作为一个提示，更警惕ASD筛查工作。自闭症研究2019，12：967-975。(c)2019年国际自闭症研究学会，Wiley Periodicals，Inc。我们研究了在母亲和儿童的大样本中，怀孕期间常见的并发症是否与自闭症谱系障碍（ASD）有关。我们的研究结果表明，以高血压为标志的疾病与ASD之间存在关联，但与以高血糖为标志的疾病和ASD之间没有关联。对于患有非ASD的发育障碍的儿童，这种关联是相似的，这表明这种关系可能不是ASD特有的。
Previous studies have shown complications of pregnancy, often examined in aggregate, to be associated with autism spectrum disorder (ASD). Results for specific complications, such as maternal diabetes and hypertension, have not been uniformly consistent and should be investigated independently in relation to ASD in a large community-based sample. The Study to Explore Early Development (SEED), a US multisite case-control study, enrolled children born in 2003-2006 at 2-5 years of age. Children were classified into three groups based on confirmation of ASD (n = 698), non-ASD developmental delay (DD; n = 887), or controls drawn from the general population (POP; n = 979). Diagnoses of any diabetes or hypertensive disorder during pregnancy were identified from prenatal medical records and maternal self-report. Logistic regression models estimated adjusted odds ratios (aOR) and confidence intervals (CI) adjusting for maternal age, race/ethnicity, education, smoking during pregnancy, and study site. Models for hypertension were additionally adjusted for parity and plurality. Among 2,564 mothers, we identified 246 (9.6%) with any diabetes and 386 (15.1%) with any hypertension in pregnancy. After adjustment for covariates, any diabetes during pregnancy was not associated with ASD (aOR = 1.10 [95% CI 0.77, 1.56]), but any hypertension was associated with ASD (aOR = 1.69 [95% CI 1.26, 2.26]). Results were similar for DD, and any diabetes (aOR = 1.29 [95% CI 0.94, 1.78]) or any hypertension (aOR = 1.71 [95% CI 1.30, 2.25]). Some pregnancy complications, such as hypertension, may play a role in autism etiology and can possibly serve as a prompt for more vigilant ASD screening efforts. Autism Res 2019, 12: 967-975. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary We studied if common complications in pregnancy are associated with autism spectrum disorder (ASD) in a large sample of mothers and children. Our results show an association between conditions marked by high blood pressure and ASD, but no association with conditions marked by high blood sugar and ASD. Associations were similar for children who had a developmental disorder that was not ASD, suggesting that this relationship may not be specific to ASD.