Maternal Vitamin D Levels During Pregnancy and Offspring Autism Spectrum Disorder,Biological Psychiatry

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Maternal Vitamin D Levels During Pregnancy and Offspring Autism Spectrum Disorder
Biological Psychiatry ( IF 10.6 ) Pub Date : 2021-07-21 , DOI: 10.1016/j.biopsych.2021.07.012
Andre Sourander ₁ , Subina Upadhyaya ₂ , Heljä-Marja Surcel ₃ , Susanna Hinkka-Yli-Salomäki ₂ , Keely Cheslack-Postava ₄ , Sanju Silwal ₂ , Minna Sucksdorff ₅ , Ian W McKeague ₆ , Alan S Brown ₇

Affiliation

Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Turku, Finland; INVEST (Inequalities, Interventions and a New Welfare State) Research Flagship, University of Turku, Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland; New York State Psychiatric Institute, Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.
Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Turku, Finland.
Faculty of Medicine, University of Oulu, Oulu, Finland; Biobank Borealis of Northern Finland, Oulu, Finland.
New York State Psychiatric Institute, Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.
Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Turku, Finland; Department of Pediatrics, Turku University Hospital, Turku, Finland.
Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York.
New York State Psychiatric Institute, Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.

Background

Findings from previous studies on maternal 25-hydroxyvitamin D [25(OH)D] levels during pregnancy and autism spectrum disorder (ASD) in offspring are inconsistent.

Methods

The association between maternal 25(OH)D levels during pregnancy and offspring ASD was examined using data from a nationwide population-based register with a nested case-control study design. The ASD cases (n = 1558) were born between 1987 and 2004 and received a diagnosis of ASD by 2015; cases were matched with an equal number of controls. Maternal 25(OH)D levels during pregnancy were measured using quantitative immunoassay from maternal sera collected during the first and early second trimesters and archived in the national biobank of the Finnish Maternity Cohort. Conditional logistic regression examined the association between maternal 25(OH)D levels and offspring ASD.

Results

In the adjusted model, there was a significant association between increasing log-transformed maternal 25(OH)D levels and decreasing risk of offspring ASD (adjusted odds ratio [aOR] 0.75, 95% confidence interval [CI] 0.62–0.92, p = .005). Analyses by quintiles of maternal 25(OH)D levels revealed increased odds for ASD in the 2 lowest quintiles, <20 (aOR 1.36, 95% CI 1.03–1.79, p = .02) and 20–39 (aOR 1.31, 95% CI 1.01–1.70, p = .04), compared with the highest quintile. The increased risk of ASD was observed in association with deficient (<30 nmol/L) (aOR 1.44, 95% CI 1.15–1.81, p = .001) and insufficient (30–49.9 nmol/L) maternal 25(OH)D levels (aOR 1.26, 95% CI 1.04–1.52, p = .01) compared with sufficient levels.

Conclusions

This finding has implications for understanding the role of maternal vitamin D during fetal brain development and increased risk of ASD.

中文翻译：

怀孕期间母亲的维生素 D 水平和后代自闭症谱系障碍

背景

以往关于孕期母体 25-羟基维生素 D [25(OH)D] 水平和后代自闭症谱系障碍 (ASD) 水平的研究结果不一致。

方法

使用来自全国人口登记册的数据和巢式病例对照研究设计，检查了孕期母亲 25(OH)D 水平与后代 ASD 之间的关联。ASD 病例 ( n = 1558) 出生于 1987 年至 2004 年之间，到 2015 年被诊断为 ASD；病例与相同数量的对照相匹配。使用定量免疫测定法测量怀孕期间母亲的 25(OH)D 水平，该血清来自妊娠早期和中期早期收集的母亲血清，并存档在芬兰孕妇队列的国家生物库中。条件逻辑回归检查了母体 25(OH)D 水平与后代 ASD 之间的关联。

结果

在调整后的模型中，增加对数转换的母体 25(OH)D 水平与降低后代 ASD 风险之间存在显着关联（调整后的比值比 [aOR] 0.75，95% 置信区间 [CI] 0.62–0.92，p = .005）。按五分位数对母体 25(OH)D 水平进行的分析显示，在 2 个最低的五分位数 <20（aOR 1.36，95% CI 1.03-1.79，p = .02）和 20-39（aOR 1.31，95%）中，ASD 的几率增加CI 1.01–1.70，p = .04)，与最高五分位数相比。观察到 ASD 风险增加与母体 25(OH)D不足 (<30 nmol/L) (aOR 1.44, 95% CI 1.15–1.81, p = .001) 和不足 (30–49.9 nmol/L) 有关水平（aOR 1.26，95% CI 1.04–1.52，p = .01) 与足够的水平相比。