Childhood neurodevelopmental disorders and maternal hypertensive disorder of pregnancy
Childhood neurodevelopmental disorders and maternal hypertensive disorder of pregnancy
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儿童期神经发育障碍与妊娠期母体高血压疾病
DOI：
10.1111/dmcn.14893
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发表时间：
2021-04-21
影响因子：
3.8
通讯作者：
Kuo, Pao-Lin
中科院分区：
文献类型：
--
作者：
Chen, Kuan-Ru;Yu, Tsung;Kuo, Pao-Lin
目的探讨母亲慢性高血压和妊娠高血压综合征（PIH）/先兆子痫与儿童神经发育障碍（NDDs）在一个大规模的人口为基础的coherents.Method的关联，我们进行了一个链接台湾国民健康保险研究数据库队列研究2004年和2008年之间出生的儿童（n=877 233）。从出生到2015年底，确定了自闭症谱系障碍（ASD）、注意力缺陷/多动障碍（ADHD）、发育迟缓、智力残疾、脑瘫（CP）和癫痫/婴儿痉挛症的诊断。考克斯比例风险模型进行了调整潜在的混杂因素，以估计母亲的妊娠高血压疾病对儿童outcomes.Results的影响相比，未暴露的母亲的后代，后代与慢性高血压或妊高征/先兆子痫的母亲表现出增加的风险，发展成一个广泛的NDD。慢性高血压与ADHD风险增加相关（风险比1.22，95%置信区间[CI] 1.13-1. 31）、发育迟缓（1.29，1.21-1.38），智力残疾（1.67，1.43-1.95），CP（1.45，1.14-1.85）和癫痫/婴儿痉挛症（1.31，1.10-1.56），而妊高征/先兆子痫与ASD的风险增加相关（1.27、1.12-1.43）、多动症（1.23，1.17-1.29），发育迟缓（1.29，1.24-1.35），智力残疾校正潜在混杂因素后，后代的癫痫/婴儿痉挛（1.53，1.37-1.71）、CP（1.44，1.22-1.70）和癫痫/婴儿痉挛（1.36，1.22-1.52）。母亲糖尿病，早产，或胎儿生长受限的共同发生进一步增加了risk.Interpretation慢性高血压或妊高征/先兆子痫似乎足以增加儿童NDD的风险。
Aim To examine the association of maternal chronic hypertension and pregnancy-induced hypertension (PIH)/preeclampsia with childhood neurodevelopmental disorders (NDDs) in a large-scale population-based cohort.Method We conducted a linked Taiwan National Health Insurance Research Database cohort study of children born between 2004 and 2008 (n=877 233). Diagnoses of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), developmental delay, intellectual disability, cerebral palsy (CP), and epilepsy/infantile spasms were identified from birth to the end of 2015. Cox proportional hazards models were fitted with adjustment for potential confounders to estimate the effect of maternal hypertensive disorder of pregnancy on childhood outcomes.Results Compared with the offspring of unexposed mothers, offspring of mothers with chronic hypertension or PIH/preeclampsia exhibited increased risk of developing a wide spectrum of NDDs. Chronic hypertension was associated with increased risks of ADHD (hazard ratio 1.22, 95% confidence interval [CI] 1.13-1. 31), developmental delay (1.29, 1.21-1.38), intellectual disability (1.67, 1.43-1.95), CP (1.45, 1.14-1.85), and epilepsy/infantile spasms (1.31, 1.10-1.56) in the offspring, whereas PIH/preeclampsia was associated with increased risks of ASD (1.27, 1.12-1.43), ADHD (1.23, 1.17-1.29), developmental delay (1.29, 1.24-1.35), intellectual disability (1.53, 1.37-1.71), CP (1.44, 1.22-1.70), and epilepsy/infantile spasms (1.36, 1.22-1.52) in the offspring after adjustment for potential confounders. The co-occurrence of maternal diabetes, preterm deliveries, or fetal growth restriction further increased the risk.Interpretation Chronic hypertension or PIH/preeclampsia seems to be sufficient to increase the risk of childhood NDDs.