母亲孕期补充叶酸与其子女孤独症谱系障碍发病风险的Meta分析

Association between maternal folate supplementation during pregnancy and the risk of autism spectrum disorder in the offspring: a Meta analysis

摘要:

目的 定量综合分析母亲孕期补充叶酸与其子女孤独症谱系障碍 （ASD）发病风险的相关性。方法 计算机全面检索PubMed、Embase、Scopus、Corchrane Liabrary、EBSCO、中国知网、万方、维普及中国生物医学文献数据库等电子数据库，收集有关母亲孕期叶酸补充与儿童ASD发病风险的文献，以OR及其95% CI为合并效应量，运用Stata 12.0软件进行Meta分析，并进行发表偏倚评估和敏感性分析。结果 根据纳入及排除标准共纳入10篇文献，包含15项研究，累计病例4 459例，对照1 225 835例。Meta分析结果显示，总体人群中母亲孕期补充叶酸可显著降低其子女ASD发病风险 （OR=0.798，95% CI：0.669~0.952，P=0.012）。亚组分析结果显示，亚洲人群中母亲孕期补充叶酸可能与其子女ASD发病风险降低有关 （OR=0.664，95% CI：0.428~1.032），但未达到统计学意义 （P=0.069）；西方人群中母亲孕期补充叶酸可降低其子女ASD发病风险 （OR=0.817，95% CI：0.671~0.996，P=0.045）。结论 母亲孕期补充叶酸可能可降低其子女ASD发病风险，在西方人群中效果较明显。

Abstract:

Objective To quantitatively and comprehensively investigate the association between maternal folate supplementation during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring. Methods PubMed, Embase, Scopus, Cochrane Library, EBSCO, CNKI, Wanfang Data, VIP Database, and Chinese Biomedical Database were searched to collect the articles on maternal folate supplementation during pregnancy and the risk of ASD in children. Odds ratio (OR) and 95% confidence interval (CI) were used to determine the effect size. Stata 12.0 software was used for the Meta analysis. Publication bias evaluation and sensitivity analysis were also performed. Results A total of 10 articles were included according to the inclusion and exclusion criteria, including 15 studies which involved 4 459 cases and 1 225 835 controls. The Meta analysis showed that maternal folate supplementation during pregnancy significantly reduced the risk of ASD in the offspring in the total population (OR=0.798, 95%CI:0.669-0.952, P=0.012). The subgroup analysis revealed that maternal folate supplementation during pregnancy was associated with a reduced risk of ASD in the offspring in both the Asian population (OR=0.664, 95%CI:0.428-1.032, P=0.069) and the Western population (OR=0.817, 95%CI:0.671-0.996, P=0.045). Conclusions Maternal folate supplementation during pregnancy may reduce the risk of ASD in the offspring, especially in the Western population.