Asociación entre Trastorno del Espectro Autista y Diabetes Mellitus Gestacional en hospitales de Nuevo Chimbote y Chimbote
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Publicado:
Aug 24, 2026
Palabras clave:
Trastorno del espectro autista; diabetes mellitus gestacional; hipertensión arterial gestacional; parto por cesárea; factores perinatales
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Resumen
El trastorno del espectro autista (TEA) tiene etiología multifactorial. Las alteraciones metabólicas e hipertensivas gestacionales podrían incrementar su riesgo, pero la evidencia en población peruana es limitada. Objetivo: Determinar la asociación entre el riesgo de TEA y la diabetes mellitus gestacional (DMG) en hospitales de Chimbote y Nuevo Chimbote. Materiales y métodos: Estudio observacional, retrospectivo de casos y controles que incluyó 81 casos con TEA y 162 controles (n = 243). Se evaluaron variables maternas y gestacionales. El riesgo se estimó mediante regresión logística multivariada, calculando Odds Ratios ajustados (ORa) con intervalos de confianza (IC) al 95%. Resultados: Los predictores independientes de TEA en el modelo ajustado (prueba Hosmer-Lemeshow, p = 0,477) fueron: la hipertensión arterial gestacional (HTAG) (ORa = 3,39; IC 95%: 1,53–7,51; p = 0,003), la DMG (ORa = 2,63; IC 95%: 1,14–6,07; p = 0,024), el sexo masculino (ORa = 2,50; IC 95%: 1,32–4,74; p = 0,005) y el nacimiento por cesárea (ORa = 2,14; IC 95%: 1,19–3,84; p = 0,011). La obesidad pregestacional y las infecciones gestacionales perdieron significancia tras el ajuste, descartándose como factores causales directos. Conclusión: La exposición prenatal a HTAG y DMG, así como el parto por cesárea y el sexo masculino, son factores de riesgo independientes para el TEA. Estos hallazgos resaltan la urgencia de optimizar el control metabólico y cardiovascular materno durante el embarazo para proteger el neurodesarrollo temprano.
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Paredes Alvarez, A. (2026). Asociación entre Trastorno del Espectro Autista y Diabetes Mellitus Gestacional en hospitales de Nuevo Chimbote y Chimbote. Revista Médica Del Santa, 1(1), 25 - 31. https://doi.org/10.71173/rev.medica.santa.2026.v1n1.04
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Kunasegaran T, Balasubramaniam VRMT, Thirunavuk Arasoo VJ, Palanisamy UD, Tan YK, Ramadas A. Diet, lifestyle and gut microbiota composition among Malaysian women with gestational diabetes mellitus: a prospective cohort study. Sci Rep [Internet]. 2024;14(1):1–15. Disponible en: https://www.nature.com/articles/s41598-024-57627-5
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Ullah N, Tuerdi A, Mijiti Y, Hassan S, Ali DSM, Bashir R. Outcomes of gestational diabetes in newborns. Saudi J Med Pharm Sci [Internet]. 2024;10(02):125–31. Disponible en: http://dx.doi.org/10.36348/sjmps.2024.v10i02.011
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Liu X, Guo C, Zou M-Y, Feng F-M, Liang S-M, Chen W-X, et al. Association between maternal gestational diabetes mellitus and the risk of autism spectrum disorder in offspring. Zhongguo Dang Dai Er Ke Za Zhi [Internet]. 2023;25(8):818–23. Disponible en: http://dx.doi.org/10.7499/j.issn.1008-8830.2301021
Khanom F, Chowdhury S, Ahmed S, Moniruzzaman, Ahmed MSA. Association of autism spectrum disorder and gestational diabetes mellitus of mothers in Bangladesh. Indian J Community Health [Internet]. 2015;27(3):391–7. Disponible en: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/591
Krakowiak P, Walker CK, Bremer AA, Baker AS, Ozonoff S, Hansen RL, et al. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics [Internet]. 2012;129(5):e1121-8. Disponible en: http://dx.doi.org/10.1542/peds.2011-2583
Guo D, Ju R, Dai J, Zhang H. Autism spectrum disorders in offspring exposed to maternal gestational diabetes: A meta-analysis and systematic review. Rev J Autism Dev Disord [Internet]. 2023; Disponible en: http://dx.doi.org/10.1007/s40489-023-00380-8
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Cordero C, Windham GC, Schieve LA, Fallin MD, Croen LA, Siega-Riz AM, et al. Maternal diabetes and hypertensive disorders in association with autism spectrum disorder. Autism Res [Internet]. 2019;12(6):967–75. Disponible en: http://dx.doi.org/10.1002/aur.2105
Atkinson JA, Gordon HG, Tong S, Walker SP, Mehdipour P, Lindquist AC, et al. Hypertensive disorders of pregnancy and childhood neurodevelopment: A systematic review and meta-analysis. PLoS Med [Internet]. 2025;22(9):e1004558. Disponible en: http://dx.doi.org/10.1371/journal.pmed.1004558
Chen S, Zhao S, Dalman C, Karlsson H, Gardner R. Association of maternal diabetes with neurodevelopmental disorders: autism spectrum disorders, attention deficit/hyperactivity disorder and intellectual disability. Int J Epidemiol [Internet]. 2021;50(2):459–74. Disponible en: http://dx.doi.org/10.1093/ije/dyaa212
Zhang T, Sidorchuk A, Sevilla-Cermeño L, Vilaplana-Pérez A, Chang Z, Larsson H, et al. Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: A systematic review and meta-analysis: A systematic review and meta-analysis. JAMA Netw Open [Internet]. 2019;2(8):e1910236. Disponible en: http://dx.doi.org/10.1001/jamanetworkopen.2019.10236
Curran EA, O’Neill SM, Cryan JF, Kenny LC, Dinan TG, Khashan AS, et al. Research review: Birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. J Child Psychol Psychiatry [Internet]. 2015;56(5):500–8. Disponible en: http://dx.doi.org/10.1111/jcpp.12351
Al-Zalabani AH, Al-Jabree AH, Zeidan ZA. Is cesarean section delivery associated with autism spectrum disorder? Neurosciences (Riyadh) [Internet]. 2019;24(1):11–5. Disponible en: http://dx.doi.org/10.17712/nsj.2019.1.20180303
Yip BHK, Leonard H, Stock S, Stoltenberg C, Francis RW, Gissler M, et al. Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births. Int J Epidemiol [Internet]. 2017;46(2):429–39. Disponible en: http://dx.doi.org/10.1093/ije/dyw336
Loomes R, Hull L, Mandy WPL. What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry [Internet]. 2017;56(6):466–74. Disponible en: http://dx.doi.org/10.1016/j.jaac.2017.03.013
Werling DM, Geschwind DH. Sex differences in autism spectrum disorders. Curr Opin Neurol [Internet]. 2013;26(2):146–53. Disponible en: http://dx.doi.org/10.1097/WCO.0b013e32835ee548
Surén P, Gunnes N, Roth C, Bresnahan M, Hornig M, Hirtz D, et al. Parental obesity and risk of autism spectrum disorder. Pediatrics [Internet]. 2014;133(5):e1128-38. Disponible en: http://dx.doi.org/10.1542/peds.2013-3664
Wang Y, Tang S, Xu S, Weng S, Liu Z. Maternal body mass index and risk of autism spectrum disorders in offspring: A meta-analysis. Sci Rep [Internet]. 2016;6(1):34248. Disponible en: http://dx.doi.org/10.1038/srep34248
Modabbernia A, Velthorst E, Reichenberg A. Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses. Mol Autism [Internet]. 2017;8(1). Disponible en: https://pubmed.ncbi.nlm.nih.gov/28331572/
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Yenkoyan K, Mkhitaryan M, Bjørklund G. Environmental risk factors in autism spectrum disorder: A narrative review. Curr Med Chem [Internet]. 2024;31. Disponible en: http://dx.doi.org/10.2174/0109298673252471231121045529
Jiang H-Y, Xu L-L, Shao L, Xia R-M, Yu Z-H, Ling Z-X, et al. Maternal infection during pregnancy and risk of autism spectrum disorders: A systematic review and meta-analysis. Brain Behav Immun [Internet]. 2016;58:165–72. Disponible en: http://dx.doi.org/10.1016/j.bbi.2016.06.005
Atladóttir HO, Thorsen P, Østergaard L, Schendel DE, Lemcke S, Abdallah M, et al. Maternal infection requiring hospitalization during pregnancy and autism spectrum disorders. J Autism Dev Disord [Internet]. 2010;40(12):1423–30. Disponible en: http://dx.doi.org/10.1007/s10803-010-1006-y
Jiang C, Wen H, Hu T, Liu Y, Dai X, Chen Y. Perinatal characteristics and pregnancy outcomes of advanced maternal age women with gestational diabetes mellitus: A retrospective cohort study. Health Sci Rep [Internet]. 2024;7(2). Disponible en: http://dx.doi.org/10.1002/hsr2.1903
Yu Y, Ozonoff S, Miller M. Assessment of autism Spectrum Disorder. Assessment [Internet]. 2024;31(1):24–41. Disponible en: http://dx.doi.org/10.1177/10731911231173089
Bosetti C, Ferrini L, Ferrari AR, Bartolini E, Calderoni S. Children with Autism Spectrum Disorder and abnormalities of clinical EEG: A qualitative review. J Clin Med [Internet]. 2024;13(1):279. Disponible en: http://dx.doi.org/10.3390/jcm13010279
Lin J, Costa MA, Rezende VL, Nascimento RR, Ambrósio PG, Madeira K, et al. Risk factors and clinical profile of autism spectrum disorder in southern Brazil. J Psychiatr Res [Internet]. 2024;169:105–12. Disponible en: http://dx.doi.org/10.1016/j.jpsychires.2023.11.033
Xiang AH, Wang X, Martinez MP, Walthall JC, Curry ES, Page K, et al. Association of maternal diabetes with autism in offspring. JAMA [Internet]. 2015;313(14):1425. Disponible en: http://dx.doi.org/10.1001/jama.2015.2707
Grove J, Autism Spectrum Disorder Working Group of the Psychiatric Genomics Consortium, Ripke S, Als TD, Mattheisen M, Walters RK, et al. Identification of common genetic risk variants for autism spectrum disorder. Nat Genet [Internet]. 2019;51(3):431–44. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30804558/
Kjerpeseth LJ, Hjellvik V, Gulseth HL, Karlstad Ø, Lopez-Doriga Ruiz P, Wensaas K A, et al. Prevalence and treatment of gestational diabetes in Norway 2010–2020. Diabetes Res Clin Pract [Internet]. 2024;207(111025):111025. Disponible en: http://dx.doi.org/10.1016/j.diabres.2023.111025
Prado Herrera MF, Guerrero-Aguilar AS, Alatrista-Gutiérrez-Vda. Bambarén M del S, Vela-Ruiz JM, Lama-Morales RA. Diabetes gestacional: Impacto de los factores de riesgo en Latinoamérica. Investigación Materno Perinatal [Internet]. 2023;12(1):33 43. Disponible en: http://dx.doi.org/10.33421/inmp.2023317
Villena Chávez J. Diabetes mellitus en el Perú: impacto sobre la salud. Recomendaciones para prevención y atención integral [Internet]. Org.pe. Disponible en: https://anmperu.org.pe/sites/default/files/4.%20Rev%20Diabetes%20Mellitus%20AN M.pdf
Liu X, Zhu Y, Seamans M, Nianogo R, Janzen C, Fei Z, et al. Gestational diabetes mellitus and risk of neurodevelopmental disorders in young offspring: does the risk differ by race and ethnicity? Am J Obstet Gynecol MFM [Internet]. 2024;6(1):101217. Disponible en: http://dx.doi.org/10.1016/j.ajogmf.2023.101217
Riaz M, Sheikh A, Simmons D. Chapter 15 - hyperglycemia in pregnancy. En: Basit A, Ahmedani MY, editores. BIDE’ s Diabetes Desk Book. Elsevier; 2024. p. 317–35. Disponible en: https://doi.org/10.1016/B978-0-443-22106-4.00009-7
Kwak SH, Kim S-H, Cho YM, Go MJ, Cho YS, Choi SH, et al. A genome-wide association study of gestational diabetes mellitus in Korean women. Diabetes [Internet]. 2012;61(2):531–41. Disponible en: http://dx.doi.org/10.2337/db11-1034
Ray GW, Zeng Q, Kusi P, Zhang H, Shao T, Yang T, et al. Genetic and inflammatory factors underlying gestational diabetes mellitus: a review. Front Endocrinol (Lausanne) [Internet]. 2024;15. Disponible en: http://dx.doi.org/10.3389/fendo.2024.1399694
Mavroeidi I, Manta A, Asimakopoulou A, Syrigos A, Paschou SA, Vlachaki E, et al. The role of the glycemic index and glycemic load in the dietary approach of gestational diabetes mellitus. Nutrients [Internet]. 2024;16(3):399. Disponible en: https://www.mdpi.com/2072-6643/16/3/399
Lizárraga D, Gómez-Gil B, García-Gasca T, Ávalos-Soriano A, Casarini L, Salazar-Oroz A, et al. Gestational diabetes mellitus: genetic factors, epigenetic alterations, and microbial composition. Acta Diabetol [Internet]. 2023;61(1):1–17. Disponible en: http://dx.doi.org/10.1007/s00592-023-02176-y
Kunasegaran T, Balasubramaniam VRMT, Thirunavuk Arasoo VJ, Palanisamy UD, Tan YK, Ramadas A. Diet, lifestyle and gut microbiota composition among Malaysian women with gestational diabetes mellitus: a prospective cohort study. Sci Rep [Internet]. 2024;14(1):1–15. Disponible en: https://www.nature.com/articles/s41598-024-57627-5
American Diabetes Association Professional Practice Committee, ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, et al. 15. Management of diabetes in pregnancy: standards of care in diabetes—2024. Diabetes Care [Internet]. 2024;47(Supplement_1):S282–94. Disponible en: http://dx.doi.org/10.2337/dc24-s015
Ullah N, Tuerdi A, Mijiti Y, Hassan S, Ali DSM, Bashir R. Outcomes of gestational diabetes in newborns. Saudi J Med Pharm Sci [Internet]. 2024;10(02):125–31. Disponible en: http://dx.doi.org/10.36348/sjmps.2024.v10i02.011
Boyd AR, Conway DL. Gestational Diabetes Mellitus [Internet]. Queenan’s Management of High‐Risk Pregnancy. Wiley; 2024. p. 156–60. Disponible en: http://dx.doi.org/10.1002/9781119636540.ch19
Liu X, Guo C, Zou M-Y, Feng F-M, Liang S-M, Chen W-X, et al. Association between maternal gestational diabetes mellitus and the risk of autism spectrum disorder in offspring. Zhongguo Dang Dai Er Ke Za Zhi [Internet]. 2023;25(8):818–23. Disponible en: http://dx.doi.org/10.7499/j.issn.1008-8830.2301021
Khanom F, Chowdhury S, Ahmed S, Moniruzzaman, Ahmed MSA. Association of autism spectrum disorder and gestational diabetes mellitus of mothers in Bangladesh. Indian J Community Health [Internet]. 2015;27(3):391–7. Disponible en: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/591
Krakowiak P, Walker CK, Bremer AA, Baker AS, Ozonoff S, Hansen RL, et al. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics [Internet]. 2012;129(5):e1121-8. Disponible en: http://dx.doi.org/10.1542/peds.2011-2583
Guo D, Ju R, Dai J, Zhang H. Autism spectrum disorders in offspring exposed to maternal gestational diabetes: A meta-analysis and systematic review. Rev J Autism Dev Disord [Internet]. 2023; Disponible en: http://dx.doi.org/10.1007/s40489-023-00380-8
Xu R-T, Chang Q-X, Wang Q-Q, Zhang J, Xia L-X, Zhong N, et al. Association between hypertensive disorders of pregnancy and risk of autism in offspring: a systematic review and meta-analysis of observational studies. Oncotarget [Internet]. 2018;9(1):1291–301. Disponible en: http://dx.doi.org/10.18632/oncotarget.23030
Cordero C, Windham GC, Schieve LA, Fallin MD, Croen LA, Siega-Riz AM, et al. Maternal diabetes and hypertensive disorders in association with autism spectrum disorder. Autism Res [Internet]. 2019;12(6):967–75. Disponible en: http://dx.doi.org/10.1002/aur.2105
Atkinson JA, Gordon HG, Tong S, Walker SP, Mehdipour P, Lindquist AC, et al. Hypertensive disorders of pregnancy and childhood neurodevelopment: A systematic review and meta-analysis. PLoS Med [Internet]. 2025;22(9):e1004558. Disponible en: http://dx.doi.org/10.1371/journal.pmed.1004558
Chen S, Zhao S, Dalman C, Karlsson H, Gardner R. Association of maternal diabetes with neurodevelopmental disorders: autism spectrum disorders, attention deficit/hyperactivity disorder and intellectual disability. Int J Epidemiol [Internet]. 2021;50(2):459–74. Disponible en: http://dx.doi.org/10.1093/ije/dyaa212
Zhang T, Sidorchuk A, Sevilla-Cermeño L, Vilaplana-Pérez A, Chang Z, Larsson H, et al. Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: A systematic review and meta-analysis: A systematic review and meta-analysis. JAMA Netw Open [Internet]. 2019;2(8):e1910236. Disponible en: http://dx.doi.org/10.1001/jamanetworkopen.2019.10236
Curran EA, O’Neill SM, Cryan JF, Kenny LC, Dinan TG, Khashan AS, et al. Research review: Birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. J Child Psychol Psychiatry [Internet]. 2015;56(5):500–8. Disponible en: http://dx.doi.org/10.1111/jcpp.12351
Al-Zalabani AH, Al-Jabree AH, Zeidan ZA. Is cesarean section delivery associated with autism spectrum disorder? Neurosciences (Riyadh) [Internet]. 2019;24(1):11–5. Disponible en: http://dx.doi.org/10.17712/nsj.2019.1.20180303
Yip BHK, Leonard H, Stock S, Stoltenberg C, Francis RW, Gissler M, et al. Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births. Int J Epidemiol [Internet]. 2017;46(2):429–39. Disponible en: http://dx.doi.org/10.1093/ije/dyw336
Loomes R, Hull L, Mandy WPL. What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry [Internet]. 2017;56(6):466–74. Disponible en: http://dx.doi.org/10.1016/j.jaac.2017.03.013
Werling DM, Geschwind DH. Sex differences in autism spectrum disorders. Curr Opin Neurol [Internet]. 2013;26(2):146–53. Disponible en: http://dx.doi.org/10.1097/WCO.0b013e32835ee548
Surén P, Gunnes N, Roth C, Bresnahan M, Hornig M, Hirtz D, et al. Parental obesity and risk of autism spectrum disorder. Pediatrics [Internet]. 2014;133(5):e1128-38. Disponible en: http://dx.doi.org/10.1542/peds.2013-3664
Wang Y, Tang S, Xu S, Weng S, Liu Z. Maternal body mass index and risk of autism spectrum disorders in offspring: A meta-analysis. Sci Rep [Internet]. 2016;6(1):34248. Disponible en: http://dx.doi.org/10.1038/srep34248
Modabbernia A, Velthorst E, Reichenberg A. Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses. Mol Autism [Internet]. 2017;8(1). Disponible en: https://pubmed.ncbi.nlm.nih.gov/28331572/
37.
Yenkoyan K, Mkhitaryan M, Bjørklund G. Environmental risk factors in autism spectrum disorder: A narrative review. Curr Med Chem [Internet]. 2024;31. Disponible en: http://dx.doi.org/10.2174/0109298673252471231121045529
Jiang H-Y, Xu L-L, Shao L, Xia R-M, Yu Z-H, Ling Z-X, et al. Maternal infection during pregnancy and risk of autism spectrum disorders: A systematic review and meta-analysis. Brain Behav Immun [Internet]. 2016;58:165–72. Disponible en: http://dx.doi.org/10.1016/j.bbi.2016.06.005
Atladóttir HO, Thorsen P, Østergaard L, Schendel DE, Lemcke S, Abdallah M, et al. Maternal infection requiring hospitalization during pregnancy and autism spectrum disorders. J Autism Dev Disord [Internet]. 2010;40(12):1423–30. Disponible en: http://dx.doi.org/10.1007/s10803-010-1006-y
Jiang C, Wen H, Hu T, Liu Y, Dai X, Chen Y. Perinatal characteristics and pregnancy outcomes of advanced maternal age women with gestational diabetes mellitus: A retrospective cohort study. Health Sci Rep [Internet]. 2024;7(2). Disponible en: http://dx.doi.org/10.1002/hsr2.1903