prenatal risk factors

产前危险因素
  • 文章类型: Journal Article
    这项研究检查了产前大麻暴露与自闭症谱系障碍(ASD)诊断和特征之间的关联。来自美国国立卫生研究院资助的对儿童健康结果的环境影响联盟的34个队列中的11,570名儿童(1-18岁;53%的男性;25%的西班牙裔;60%的白人)的样本被纳入分析。广义线性混合模型的结果复制了先前的研究,表明在控制相关协变量时,产前大麻暴露与儿童ASD特征之间的关联并不显著。特别是烟草暴露。儿童生物性别并未减轻产前大麻暴露与ASD之间的关联。在大样本中,连续测量ASD性状,没有证据表明产前接触大麻会增加ASD的风险.这项工作有助于通过解决对统计能力和ASD测量的担忧来澄清以前的混合发现。
    This study examined the association between prenatal cannabis exposure and autism spectrum disorder (ASD) diagnoses and traits. A total sample of 11,570 children (ages 1-18; 53% male; 25% Hispanic; 60% White) from 34 cohorts of the National Institutes of Health-funded environmental influences on child health outcomes consortium were included in analyses. Results from generalized linear mixed models replicated previous studies showing that associations between prenatal cannabis exposure and ASD traits in children are not significant when controlling for relevant covariates, particularly tobacco exposure. Child biological sex did not moderate the association between prenatal cannabis exposure and ASD. In a large sample and measuring ASD traits continuously, there was no evidence that prenatal cannabis exposure increases the risk for ASD. This work helps to clarify previous mixed findings by addressing concerns about statistical power and ASD measurement.
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  • 文章类型: Journal Article
    背景:妊娠代表了胎儿发育的脆弱性窗口。在这一关键时期,产前环境的中断会增加后代在其一生中患疾病的风险。中枢神经系统(CNS)已被证明在关键的发育窗口期间特别容易受到变化的影响。迄今为止,集中于中枢神经系统发育中断的研究主要集中在大脑上,揭示暴露于产前危险因素与神经精神疾病发病之间的相关性。然而,一些研究表明视网膜,它是中枢神经系统的一部分,在怀孕期间也容易受到子宫内改变的影响。这种变化可能会影响神经元,视网膜的胶质和血管成分,损害视网膜结构和功能,并可能损害视觉功能。
    方法:在PubMed数据库中进行搜索,以及任何有关产前危险因素的文献(药物,糖尿病,不均衡的饮食,感染,包括影响后代视网膜的糖皮质激素)。
    结果:这篇综述收集了关于细胞,妊娠期间由母体危险因素引发的视网膜结构和功能变化。我们强调了对视网膜发育的不利影响及其长期影响,提供对当前知识的批判性分析,同时强调未来研究的领域。
    结论:对对发育中的视网膜产生负面影响的产前危险因素的适当识别可能为设计预防策略和早期治疗干预提供关键线索,这些干预可能会改变子代视网膜病理。
    BACKGROUND: Pregnancy represents a window of vulnerability to fetal development. Disruptions in the prenatal environment during this crucial period can increase the risk of the offspring developing diseases over the course of their lifetime. The central nervous system (CNS) has been shown to be particularly susceptible to changes during crucial developmental windows. To date, research focused on disruptions in the development of the CNS has predominantly centred on the brain, revealing a correlation between exposure to prenatal risk factors and the onset of neuropsychiatric disorders. Nevertheless, some studies indicate that the retina, which is part of the CNS, is also vulnerable to in utero alterations during pregnancy. Such changes may affect neuronal, glial and vascular components of the retina, compromising retinal structure and function and possibly impairing visual function.
    METHODS: A search in the PubMed database was performed, and any literature concerning prenatal risk factors (drugs, diabetes, unbalanced diet, infection, glucocorticoids) affecting the offspring retina were included.
    RESULTS: This review collects evidence on the cellular, structural and functional changes occurring in the retina triggered by maternal risk factors during pregnancy. We highlight the adverse impact on retinal development and its long-lasting effects, providing a critical analysis of the current knowledge while underlining areas for future research.
    CONCLUSIONS: Appropriate recognition of the prenatal risk factors that negatively impact the developing retina may provide critical clues for the design of preventive strategies and for early therapeutic intervention that could change retinal pathology in the progeny.
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  • 文章类型: Journal Article
    抑制性控制在儿童的认知和社会情绪发展中起着重要作用。包括他们的精神病理学.已经确定,诸如社会经济地位(SES)和父母的心理病理学等环境因素与儿童的抑制控制有关。然而,在纵向研究中,很少研究抑制控制的神经相关因素与环境因素之间的关系。在本研究中,我们使用事件相关电位(ERP)组件和抑制性控制的时间频率测量来评估上下文因素之间的神经通路,包括产前SES和产妇精神病理学,以及大样本儿童中的儿童行为和情绪问题(N=560;女性占51.75%;法师=7.13岁;里程=4-11岁)。结果表明,θ功率,这是由产前SES预测的,与儿童的外化问题呈负相关,介导了它们之间的纵向和负相关关系。ERP振幅和潜伏期并不介导产前危险因素之间的纵向关联(即,产前SES和产妇心理病理学)和儿童的内在化和外在化问题。我们的发现增加了我们对将早期危险因素与儿童心理病理学联系起来的神经通路的理解。
    Inhibitory control plays an important role in children\'s cognitive and socioemotional development, including their psychopathology. It has been established that contextual factors such as socioeconomic status (SES) and parents\' psychopathology are associated with children\'s inhibitory control. However, the relations between the neural correlates of inhibitory control and contextual factors have been rarely examined in longitudinal studies. In the present study, we used both event-related potential (ERP) components and time-frequency measures of inhibitory control to evaluate the neural pathways between contextual factors, including prenatal SES and maternal psychopathology, and children\'s behavioral and emotional problems in a large sample of children (N = 560; 51.75% females; Mage = 7.13 years; Rangeage = 4-11 years). Results showed that theta power, which was positively predicted by prenatal SES and was negatively related to children\'s externalizing problems, mediated the longitudinal and negative relation between them. ERP amplitudes and latencies did not mediate the longitudinal association between prenatal risk factors (i.e., prenatal SES and maternal psychopathology) and children\'s internalizing and externalizing problems. Our findings increase our understanding of the neural pathways linking early risk factors to children\'s psychopathology.
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  • 文章类型: Journal Article
    急性白血病,主要包括急性淋巴细胞白血病(ALL)和急性髓系白血病(AML),包括血液系统癌症中的主要诊断组。由于ALL发病年龄较早,特别是,长期以来,人们一直怀疑儿童急性白血病可能起源于子宫内。这种假设促使许多调查寻求产前白血病发生的直接证明,特别是,双胞胎和“回溯研究”。疑似宫内起源也将妊娠作为一个关键的风险窗口,导致了关于小儿急性白血病的产前危险因素的丰富文献。在这篇叙述性评论中,我们叙述了儿童急性白血病子宫内起源的间接和直接证据。
    Acute leukemias, mainly consisting of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), comprise a major diagnostic group among hematologic cancers. Due to the early age at onset of ALL, particularly, it has long been suspected that acute leukemias of childhood may have an in utero origin. This supposition has motivated many investigations seeking direct proof of prenatal leukemogenesis, in particular, twin and \"backtracking studies\". The suspected in utero origin has also focused on gestation as a critical window of risk, resulting in a rich literature on prenatal risk factors for pediatric acute leukemias. In this narrative review, we recount the circumstantial and direct evidence for an in utero origin of childhood acute leukemias.
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  • 文章类型: Journal Article
    目的:研究累积产前危险因素(RFs)对幼儿发育协调障碍(DCD)的影响。
    方法:参与者(N=589,338名男孩,Mage=4.5±0.5年)来自更大的队列研究,儿童协调和活动跟踪(CATCH)。使用儿童运动评估电池-第2版评估运动协调性。根据欧洲儿童残疾学会指南,儿童被归类为DCD(DCDr)的风险。RF是通过父母完成的调查获得的。进行多元逻辑回归以检查RFs对DCD的影响。
    结果:结果表明,随着产前RFs总数的增加,儿童患DCDr的几率明显更高,在孩子出生时调整母亲的年龄后,孩子的性,孩子的年龄,婚姻状况与家庭年总收入(OR=1.48,p<0.01)。
    结论:这些发现需要进一步研究多个产前RFs的累积影响,以及RFs的特定组合是否可能比其他组合更强烈地与DCD相关。这些结果为DCD的可能原因和预防提供了额外的见解。
    OBJECTIVE: To examine the effect of cumulative prenatal risk factors (RFs) on the presence of Developmental Coordination Disorder (DCD) in young children.
    METHODS: Participants (N = 589, 338 boys, Mage = 4.5 ± 0.5 years) were from a larger cohort study, the Coordination and Activity Tracking in Children (CATCH). Motor coordination was assessed using the Movement Assessment Battery for Children- 2nd Edition. Children were classified as at risk for DCD (DCDr) based on European Academy of Childhood Disability guidelines. RFs were obtained through a parent-completed survey. A multiple logistic regression was conducted to examine the effect of the RFs on DCD.
    RESULTS: Results showed that the odds of a child having DCDr are significantly higher with a greater total number of prenatal RFs, after adjustment for mother\'s age at child\'s birth, child\'s sex, child\'s age, marital status and total annual household income (OR = 1.48, p < 0.01).
    CONCLUSIONS: These findings warrant further investigation into the cumulative impact of multiple prenatal RFs and whether specific combinations of RFs might be more strongly linked to DCD than others. These results provide additional insight into possible causes and prevention of DCD.
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  • 文章类型: Journal Article
    背景:进食障碍(ED)是严重的精神疾病,通常在早期首次亮相。宫内环境和出生时的异常与ED的风险有关。这里,我们探索,在什么影响大小下,各种这样的暴露与后代ED有关,也就是说,神经性厌食症(AN),神经性贪食症(BN),和饮食失调没有另有规定(EDNOS)。
    方法:这项基于人群的队列研究,从2021年9月至2023年8月进行,使用了1996-2014年所有活产的芬兰国家登记册(N=1,097,753)。Cox比例风险模型用于比较暴露和未暴露后代的ED风险。调整潜在的混杂因素并进行性别分层分析。
    结果:共有6614个后代被诊断患有ED;3668AN,666BN,和4248EDNOS。年轻母亲的后代AN风险较低,继续吸烟,和仪器输送,虽然老年母亲的风险更高,炎症性疾病,早产,小于胎龄,低Apgar持续吸烟和早产的后代BN风险较高,而早产较低。EDNOS的后代风险在器械递送下较低,对于年长的母亲来说更高,多囊卵巢综合征,胰岛素治疗的孕前糖尿病,抗菌治疗,早产,而且小于胎龄。发现了性别特异性关联。
    结论:几种产前和出生时暴露与后代ED有关;然而,我们不能排除孕妇BMI的混淆.然而,几种风险敞口选择性地与任一AN的风险相关联,BN,或者EDNOS,有些是性别特定的,强调对ED进行分类和性别分层分析的重要性。
    我们定义了参与不同ED发展的环境因素,作为预防措施的重要性,而且为了帮助定义所涉及的分子途径,因此从长远来看,有助于ED的药理治疗的发展。
    BACKGROUND: Eating disorders (ED) are severe psychiatric disorders, commonly debuting early. Aberrances in the intrauterine environment and at birth have been associated with risk of ED. Here, we explore if, and at what effect size, a variety of such exposures associate with offspring ED, that is, anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS).
    METHODS: This population-based cohort study, conducted from September 2021 to August 2023, used Finnish national registries of all live births in 1996-2014 (N = 1,097,753). Cox proportional hazards modeling was used to compare ED risk in exposed versus unexposed offspring, adjusting for potential confounders and performing sex-stratified analyses.
    RESULTS: A total of 6614 offspring were diagnosed with an ED; 3668 AN, 666 BN, and 4248 EDNOS. Lower risk of offspring AN was seen with young mothers, continued smoking, and instrumental delivery, while higher risk was seen with older mothers, inflammatory disorders, prematurity, small for gestational age, and low Apgar. Offspring risk of BN was higher with continued smoking and prematurity, while lower with postmature birth. Offspring risk of EDNOS was lower with instrumental delivery, higher for older mothers, polycystic ovary syndrome, insulin-treated pregestational diabetes, antibacterial treatment, prematurity, and small for gestational age. Sex-specific associations were found.
    CONCLUSIONS: Several prenatal and at birth exposures are associated with offspring ED; however, we cannot exclude confounding by maternal BMI. Nevertheless, several exposures selectively associate with risk of either AN, BN, or EDNOS, and some are sex-specific, emphasizing the importance of subtype- and sex-stratified analyses of ED.
    UNASSIGNED: We define environmental factors involved in the development of different ED, of importance as preventive measure, but also in order to aid in defining the molecular pathways involved and thus in the longer perspective contribute to the development of pharmacological treatment of ED.
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  • 文章类型: Journal Article
    背景:以前,与炎症和类固醇失调相关的母体代谢疾病的产前暴露与自闭症风险增加有关。类固醇相关的母体血清生物标志物也为患有自闭症的后代提供了子宫内类固醇环境的见解。
    目的:本研究探讨了后代孤独症与孕中期母体类固醇相关血清生物标志物之间的联系,这些标志物来自富含产前代谢综合征(PNMS)暴露的妊娠。
    方法:妊娠中期早期母体类固醇相关血清生物标志物(即,雌二醇,游离的睾酮,总睾酮,和性激素结合球蛋白)在对应于患有(N=68)和没有(N=68)自闭症的后代的怀孕之间进行了比较。多因素logistic回归分析按性别和妊娠时间分层。对由自闭症状态和PNMS暴露定义的组进行单向ANCOVA和事后测试。
    结果:雌二醇增加仅在男性中与自闭症显着相关(AOR=1.13/100pg/ml,95%CI1.01-1.27,p=0.036)和仅足月妊娠(AOR=每100pg/ml1.17,95%CI1.04-1.32,p=0.010)。自闭症状态与性激素结合球蛋白降低显着相关(AOR=0.65每50nmol/L,95%CI0.55-0.78,p<0.001)总体上以及按性别和足月妊娠状态分层时。性激素结合球蛋白与自闭症之间的负相关与PNMS暴露无关。
    结论:犹他州人口的相对种族和民族同质性限制了研究结果的普遍性。尽管在参与者亚组中,性激素结合球蛋白和雌二醇的浓度在自闭症状态方面存在显着差异,PNMS暴露的差异没有达到统计学意义,这可能反映出统计能力不足。
    结论:仅男性的母体血清雌二醇升高和两种性别的母体血清性激素结合球蛋白降低均与自闭症风险增加相关。值得进一步调查以确定类固醇,新陈代谢,和炎症过程可以相互作用,影响早孕中期的神经发育。
    Prenatal exposure to maternal metabolic conditions associated with inflammation and steroid dysregulation has previously been linked to increased autism risk. Steroid-related maternal serum biomarkers have also provided insight into the in utero steroid environment for offspring who develop autism.
    This study examines the link between autism among offspring and early second trimester maternal steroid-related serum biomarkers from pregnancies enriched for prenatal metabolic syndrome (PNMS) exposure.
    Early second trimester maternal steroid-related serum biomarkers (i.e., estradiol, free testosterone, total testosterone, and sex hormone binding globulin) were compared between pregnancies corresponding to offspring with (N = 68) and without (N = 68) autism. Multiple logistic regression analyses were stratified by sex and gestational duration. One-way ANCOVA with post hoc tests was performed for groups defined by autism status and PNMS exposure.
    Increased estradiol was significantly associated with autism only in males (AOR = 1.13 per 100 pg/ml, 95% CI 1.01-1.27, p = 0.036) and only term pregnancies (AOR = 1.17 per 100 pg/ml, 95% CI 1.04-1.32, p = 0.010). Autism status was significantly associated with decreased sex hormone binding globulin (AOR = 0.65 per 50 nmol/L, 95% CI 0.55-0.78, p < 0.001) overall and when stratified by sex and term pregnancy status. The inverse association between sex hormone binding globulin and autism was independent of PNMS exposure.
    The relative racial and ethnic homogeneity of Utah\'s population limits the generalizability of study results. Although significant differences by autism status were identified in concentrations of sex hormone binding globulin overall and of estradiol in participant subgroups, differences by PNMS exposure failed to reach statistical significance, which may reflect insufficient statistical power.
    Both elevated maternal serum estradiol in males only and low maternal serum sex hormone binding globulin in both sexes are associated with increased autism risk. Further investigation is merited to identify how steroid, metabolic, and inflammatory processes can interact to influence neurodevelopment in early second trimester.
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  • 文章类型: Journal Article
    这项测试前和测试后的准实验设计研究试点测试了一种教育干预措施,该干预措施旨在增加对产前因素的了解和改变态度,这些因素会增加36名孕妇的儿童后代肥胖风险。教育干预内容包括血糖监测,孕期体重增加,健康的生活方式选择,和母乳喂养。教育干预提供方法包括:口头,writed,和视频。在大多数主题的干预后,参与者的知识得到了改善(p=.03-.000)。干预前后他们的态度得分也不同(p=0.002)。视频传输模式是最有用的,有吸引力,最有用的方法。这项研究表明,教育干预可能会增加孕妇对后代肥胖危险因素的知识和态度。
    This pre- and post-test quasi-experimental design study pilot tested an educational intervention designed to increase knowledge of and change attitudes toward prenatal factors that increase risk of childhood offspring obesity in 36 pregnant women. Educational intervention content included monitoring blood glucose, gestational weight gain in pregnancy, healthy lifestyle choices, and breastfeeding. Education intervention delivery method included: Verbal, written, and video. Participants\' knowledge improved after the intervention for most topics (p = .03-.000). Their attitude score also differed before and after intervention (p = .002). Video delivery mode was the most useful, attractive, and most helpful method. This study showed an education intervention could potentially increase pregnant women\'s knowledge and attitudes toward offspring obesity risk factors.
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  • 文章类型: Journal Article
    湿疹是儿童常见的过敏性疾病,严重影响儿童及其家庭的生活质量。
    结果显示,非常早发性湿疹的发生率为12.4%。早产与较高的湿疹风险相关[风险比(95%置信区间):1.23(1.06-1.42)]。
    非常早发性湿疹很常见。鉴于其对儿童健康和生活质量的不利影响,这个以前被忽视的公共卫生问题需要优先考虑。此外,产妇产次可以作为婴儿湿疹风险评估和预测的指标。
    UNASSIGNED: Eczema is a common allergic disease in children, which seriously affects the quality of life of children and their families.
    UNASSIGNED: The results showed that the incidence of very-early-onset eczema was 12.4%. Primiparity was associated with a higher risk of eczema [risk ratio (95% confidence interval): 1.23 (1.06-1.42)].
    UNASSIGNED: Very-early-onset eczema is common. Given its adverse impact on children\'s health and life quality, this previously neglected public health issue needs to be prioritized. In addition, maternal parity could serve as an indicator in risk assessment and prediction for infant eczema.
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  • 文章类型: Journal Article
    怀孕期间的空气污染暴露可能是后代免疫成熟改变的危险因素。我们调查了怀孕期间的环境空气污染物与参加生命呼吸试验的哮喘母亲所生的婴儿脐带血细胞群之间的关系。对于每位患者(n=91),在整个怀孕期间提取了每日平均环境空气污染物水平的二氧化硫(SO2),一氧化氮,二氧化氮,一氧化碳,臭氧,颗粒物<10μm(PM10)或<2.5μm(PM2.5),湿度,湿度和温度。收集了91份脐带血样本,染色,并使用荧光激活细胞分选(FACS)进行评估。采用线性回归的空气污染物和细胞类型的主成分(PC)分析来定义关联。考虑到PC之间的风险因素和相关性,只有一种来自空气污染物的PC和两种来自细胞类型的PC具有统计学意义。来自空气污染物的PC的特征在于较高的PM2.5和较低的SO2水平。来自细胞类型的PC的特征是大量的CD8T细胞,CD4T细胞数量少,以及大量的浆细胞样树突状细胞(pDC)和少量的髓样DC(mDC)。怀孕期间的PM2.5水平与高pDCs数量显着相关(p=0.006),和SO2,脐带血中CD8T细胞数量高(p=0.002),CD4T细胞数量低(p=0.011)和mDCs数量低(p=4.43×10-6)。这些数据表明,环境中的SO2和PM2.5暴露与脐带血细胞类型的变化有关,而脐带血细胞类型在儿童的炎症性呼吸系统疾病中起着重要作用。
    Air pollution exposure during pregnancy may be a risk factor for altered immune maturation in the offspring. We investigated the association between ambient air pollutants during pregnancy and cell populations in cord blood from babies born to mothers with asthma enrolled in the Breathing for Life Trial. For each patient (n = 91), daily mean ambient air pollutant levels were extracted during their entire pregnancy for sulfur dioxide (SO2), nitric oxide, nitrogen dioxide, carbon monoxide, ozone, particulate matter <10 μm (PM10) or <2.5 μm (PM2.5), humidity, and temperature. Ninety-one cord blood samples were collected, stained, and assessed using fluorescence-activated cell sorting (FACS). Principal Component (PC) analyses of both air pollutants and cell types with linear regression were employed to define associations. Considering risk factors and correlations between PCs, only one PC from air pollutants and two from cell types were statistically significant. PCs from air pollutants were characterized by higher PM2.5 and lower SO2 levels. PCs from cell types were characterized by high numbers of CD8 T cells, low numbers of CD4 T cells, and by high numbers of plasmacytoid dendritic cells (pDC) and low numbers of myeloid DCs (mDCs). PM2.5 levels during pregnancy were significantly associated with high numbers of pDCs (p = 0.006), and SO2 with high numbers of CD8 T cells (p = 0.002) and low numbers of CD4 T cells (p = 0.011) and mDCs (p = 4.43 × 10-6) in cord blood. These data suggest that ambient SO2 and PM2.5 exposure are associated with shifts in cord blood cell types that are known to play significant roles in inflammatory respiratory disease in childhood.
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