妊娠期糖尿病与儿童自闭症发生风险相关性荟萃分析

Gestational diabetes mellitus and risk of autism in offspring: A meta-analysis

目的评价患妊娠期糖尿病(gestational diabetes mellitus,GDM)的孕妇,其后代患自闭症谱系障碍(autism spectrum disorder,ASD)的风险。方法通过Pub Med、Springerlink、Web of Science、EMbase、Cochrane database等电子数据库查找相关文献,检索时限截止至2016年12月。对纳入的文章进行质量评价,计算比值比(OR)及95%置信区间(CI),采用Stata12.0软件进行Meta分析。用亚组分析探索异质性的来源。结果最终纳入文献15篇,包括7篇病例对照研究和8篇队列研究。本荟萃分析纳入自闭症儿童合计10 472例,同期正常儿童合计1 624 274例。Meta分析结果显示:与正常孕妇的后代相比,患妊娠期糖尿病的孕妇其后代患自闭症的风险更高,差异有统计学意义(OR=1.44,95%CI:1.24~1.67,P<0.05)。结论患妊娠期糖尿病的孕妇,其后代发生自闭症的风险显著增加。孕妇是否患妊娠期糖尿病对于预测其后代的自闭症发生风险有一定价值。

Objective To determine whether gestational diabetes mellitus( GDM) is associated with increased risk of autism spectrum disorder( ASD) in children. Methods The literatures were searched using Pub Med,Springerlink,Web of Science,EMbase,and Cochrane database etc. for original studies up to December, 2016. Odds ratios( OR) and 95% confidence intervals( 95% CI) were calculated separately for each case group, and Stata12. 0 was used for all analyses. Subgroup analyses were carried out to explore the source of heterogeneity. Results 7 observational case-control studies and 8 cohort studies involving 10 472 autistic children and 1 624 274 non-autistic children were identified. Pooled results suggest that maternal GDM is associated with increased risk of ASD in children relative to controls [OR = 1. 44,95% CI: 1. 24 ~ 1. 67,P < 0. 05]. Conclusions Our study shows that children whose mothers get GDM may have an elevated risk of suffering from ASD relative to controls.Therefore,the evaluation of maternal GDM may have certain value in predicting risk of autism in children.