Abstract：
Although the risk of autism spectrum disorder (ASD) has been reported to be associated with interpregnancy intervals (IPIs), their association remains debatable due to inconsistent findings in existing studies. Therefore, the present study aimed to explore their association. PubMed, Embase, Web of Science, and the Cochrane Library were systematically retrieved up to May 25, 2022. An updated search was performed on May 25, 2023, to encompass recent studies. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Our primary outcome measures were expressed as adjusted odds ratios (ORs). Given various control measures for IPI and diverse IPI thresholds in the included studies, a Bayesian network meta-analysis was performed. Eight studies were included, involving 24,865 children with ASD and 2,890,289 children without ASD. Compared to an IPI of 24 to 35 months, various IPIs were significantly associated with a higher risk of ASD (IPIs < 6 months: OR = 1.63, 95% CI 1.53-1.74, n = 5; IPIs of 6-11 months: OR = 1.50, 95% CI 1.42-1.59, n = 4; IPIs of 12-23 months: OR = 1.19, 95% CI 1.12-1.23, n = 10; IPIs of 36-59 months: OR = 0.96, 95% CI 0.94-0.99, n = 2; IPIs of 60-119 months: OR = 1.15, 95% CI 1.10-1.20, n = 4; IPIs > 120 months: OR = 1.57, 95% CI 1.43-1.72, n = 4). After adjusting confounding variables, our analysis delineated a U-shaped restricted cubic spline curve, underscoring that both substantially short (< 24 months) and excessively long IPIs (> 72 months) are significantly correlated with an increased risk of ASD. Conclusion: Our analysis indicates that both shorter and longer IPIs might predispose children to a higher risk of ASD. Optimal childbearing health and neurodevelopmental outcomes appear to be associated with a moderate IPI, specifically between 36 and 60 months. What is Known: • An association between autism spectrum disorder (ASD) and interpregnancy intervals (IPIs) has been speculated in some reports. • This association remains debatable due to inconsistent findings in available studies. What is New: • Our study delineated a U-shaped restricted cubic spline curve, suggesting that both shorter and longer IPIs predispose children to a higher risk of ASD. • Optimal childbearing health and neurodevelopmental outcomes appear to be associated with a moderate IPI, specifically between 36 and 60 months.
摘要：
尽管据报道自闭症谱系障碍（ASD）的风险与妊娠间隔（IPI）有关，由于现有研究的结果不一致,他们之间的关联仍有争议.因此,本研究旨在探讨它们之间的关联。PubMed,Embase,WebofScience,截至2022年5月25日，系统检索了Cochrane图书馆。2023年5月25日进行了更新搜索，以涵盖最近的研究。使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。我们的主要结果指标表示为调整后的比值比（ORs）。考虑到IPI的各种控制措施和纳入研究中不同的IPI阈值，进行了贝叶斯网络荟萃分析.其中包括8项研究,涉及24,865名ASD儿童和2,890,289名无ASD儿童。与24到35个月的IPI相比，各种IPI与更高的ASD风险显着相关（IPI<6个月：OR=1.63，95％CI1.53-1.74，n=5；6-11个月的IPI：OR=1.50，95％CI1.42-1.59，n=4；12-23个月的IPI：OR=1.19，95％CI1.12-1.23，n=10；IPCI=1.120=1.调整混杂变量后，我们的分析描绘了一条U形约束三次样条曲线，强调显著短(<24个月)和过长(>72个月)的IPI与ASD风险增加显著相关。结论：我们的分析表明，较短和较长的IPIs都可能使儿童患ASD的风险更高。最佳的生育健康和神经发育结果似乎与中度IPI有关，特别是在36到60个月之间。已知:•在一些报告中推测了自闭症谱系障碍(ASD)与妊娠间隔(IPI)之间的关联。•由于现有研究的结果不一致，这种关联仍有争议。新增功能：•我们的研究描绘了一条U形受限三次样条曲线，这表明较短和较长的IPIs都会使儿童患ASD的风险更高。•最佳生育健康和神经发育结果似乎与中度IPI有关，特别是在36到60个月之间。
