{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:52:32Z","timestamp":1791827552185,"version":"4.3.4"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system with a complex etiology involving genetic and environmental factors. Maternal diabetes during pregnancy has been hypothesized to influence offspring MS risk through intrauterine metabolic programming, yet the evidence remains inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review and meta-analyze the association between maternal diabetes and the risk of MS in offspring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Embase, identifying 427 records. After removing 188 duplicates, 239 records were screened, 38 full-text reports were assessed for eligibility, and 4 studies met the inclusion criteria. Pooled risk ratios (RR) were calculated using both common-effect and random-effects models. Heterogeneity was assessed using the I\u00b2 statistic, and publication bias was evaluated using Egger\u2019s and Begg\u2019s tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The studies, published between 2009 and 2026, were conducted in Denmark, the USA (two studies), and Norway, utilizing diverse designs including nationwide register-based cohorts and a case-control study. The common-effect model yielded a pooled RR of 1.42 (95% CI: 1.09\u20131.85), while the random-effects model produced a non-significant pooled RR of 3.13 (95% CI: 0.68\u201314.30). Substantial heterogeneity was observed across studies (I\u00b2 = 95.2%, \u03c4\u00b2 = 2.2357,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Individual study risk ratios ranged from 0.91 (95% CI: 0.60\u20131.38) to 28.35 (95% CI: 13.33\u201360.29). Neither Egger\u2019s test (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.4364) nor Begg\u2019s test (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.1742) indicated significant publication bias, though these tests have limited power with fewer than ten studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta-analysis did not demonstrate a statistically significant association between maternal diabetes and MS risk in offspring, likely owing to substantial between-study heterogeneity and the limited number of included studies. Large, well-characterized prospective cohorts are needed to clarify this relationship, elucidate underlying mechanisms, and inform preventive strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-026-09367-9","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T03:30:16Z","timestamp":1788319816000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal diabetes as a prenatal risk factor for multiple sclerosis in offspring: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"47","author":[{"given":"Mehdi","family":"Mohammadifar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahyar","family":"Ghajarzdaeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0890-8852","authenticated-orcid":false,"given":"Mahsa","family":"Ghajarzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"issue":"2","key":"9367_CR1","first-page":"125","volume":"13","author":"M Ghajarzadeh","year":"2018","unstructured":"Ghajarzadeh M, Jalilian R, Sahraian MA, Moghadasi AN, Azimi A, Mohammadifar M et al (2018) Pain in patients with multiple sclerosis. 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