母亲孕前BMI和孕期增重与子代孤独症之间关系的研究

Association between mothers＇ body mass index before pregnancy or weight gain during pregnancy and autism in children

目的探讨母亲孕前BMI和孕期增重与子代孤独症之间的关系。方法选取2013--2014年经医疗机构确诊的181例1—5岁孤独症儿童为病例组，采用1：1病例对照研究方法选择同地区、同性别、同年龄发育正常的儿童作为对照组。按母亲孕前BMI值分为低、正常和高3组，孕期增重根据美国医学研究所标准分为低、正常和高3组，采用SPSS18．0软件进行χ^2检验和logistic回归分析。结果两组儿童年龄和性别分布均衡（χ^2=0．434，P〉0．05）。病例组母亲孕前BMI平均值为（21．28±3．80）kg／m^2，高于对照组的（19．87±2．83）kg／m^2，差异有统计学意义（Z=9．580，P〈0．05）；病例组母亲高BMI人数（10．5％）多于对照组（2．8％）；随着孕前BMI增加，子代孤独症患病风险逐渐增大，高BMI组子代孤独症发病风险是正常BMI组的3．7倍（OR=3．71，95％CI：1．34—10．24）；病例组正常BMI母亲孕期增重过度（44．1％）高于对照组（33．9％）；病例组高BMI母亲孕期增重过度（52．6％）明显高于对照组（20．0％），正常BMI（f=8．690，P〈0．05）和高BMI（Z2=4．775，P〈0．05）母亲孕期增重过度与孤独症发病有关。logistic回归分析显示，母亲孕前高BMI（调整前OR=1．89，95％CI：1．26—2．85；调整后OR=1．52，95％CI：1．19～2．27）和孕期增重过度（调整前OR=1．63，95％CI：1．08～1．25；调整后OR=1．64，95％CI：1．21～2．21）是子代孤独症发生的危险因素。结论母亲孕前超重／HE胖和孕期增重过度与子代孤独症发生有一定的关系，可能是孤独症的危险因素。

Objective To explore the relationship between mothers＇ body mass index （BMI） before pregnancy or weight gain during pregnancy and autism in children. Methods From 2013 to 2014, the 181 children with autism and 181 healthy children matched by sex and age from same area were included in this study. According to mothers＇ BMI before pregnancy, the selected cases were divided into 3 groups： low, normal and high group. Then 3 groups were divided into 3 subgroups based on mother＇ s weight gain during pregnancy： low, normal and high group, according to the recommendations of Institute of Medicine. Logistic regression analysis and χ^2 test were conducted with SPSS 18.0 sottware to analysis the relationship between mothers＇ BMI before pregnancy or weight gain during pregnancy and autism in children. Results The age and sex distributions of case group and control group were consistent（χ^2=0.434, P〉0.05）. The mothers＇ BMI before pregnancy of case group was higher than that of control group （χ^2=9.580,P〈0.05） ,which was （21.28 ±3.80）kg/m^2 for case group and （19.87 ±2.83）kg/m^2 for control group. The proportion of cases in high BMI group （10.5%） was much higher than that in control group （2.8%）. The risk of children with autism in high BMI group was 3.7 times higher than that in normal BMI group （OR = 3.71,95% CI： 1.34-10.24）. In normal BMI group, the proportion of mothers who had excessive weight gain during pregnancy was higher in case group （44.1%）than in control group （33.9%）. In high BMI group, the proportion of mothers who had excessive weight gain was higher in case group （52.6%） than in control group （20.0%）. In normal BMI group （ χ^2 = 8.690, P〈 0.05 ） and high BMI group （χ^2= 4.775, P〈 0.05 ）, the weight gain during pregnancy was associated with autism in children. Logistic regression analysis showed that mothers＇ BMI before pregnancy（unadjusted OR= 1.89,95%CI： 1.26-2.85, adjusted OR= 1.52,95%CI： 1.19-2.27） and weight gain during pregnancy were the risk factors for autism in children （unadjusted 0R=1.63, 95% CI： 1.08-1.25, adjusted OR= 1.64, 95% CI： 1.21-2.21）. Conclusion Overweight or obesity before pregnancy and excessive weight gain during pregnancy were associated with autism in children, suggesting that women who plan to be pregnant should pay attention to body weight control.