孕妇妊娠期体重增加率与儿童认知和行为发育的关系:一项出生队列研究

Association of gestational weight gain rate in pregnant women with children's cognitive and behavioral development: A birth cohort study

孕妇妊娠期体重增加率与儿童认知和行为发育的关系:一项出生队列研究

Authors：Hao X, Zhu L, Guo Y, Lu J, Yan S, Tao F, Huang K.  

Source：J Affect Disord.

DOI: 10.1016/j.jad.2024.01.154

Abstract

BACKGROUND: The evidences on the relationship between gestational weight gain rate (GWGR) and children's cognitive and behavioral development have been limited.

METHODS: A total of 3273 singleton live birth mother-child pairs from the Ma'anshan Birth Cohort in China were included in the study. Maternal GWGR was calculated based on the weights measured at multiple antenatal checkups. Children's cognitive and behavioral development were assessed by Chinese version of Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition and Achenbach Child Behavior Checklist 1.5-5. Then generalized linear models were performed for analyses.

RESULTS: In the field of children's cognitive development, excessive GWGR in the second trimester was associated with increased visual space index (VSI), fluid reasoning index (FRI) and full scale intelligence quotient (FSIQ) scores, while excessive GWGR in the third trimester was associated with decreased VSI, working memory index (WMI) and FSIQ scores. In the field of children's behavioral development, excessive GWGR in the second trimester was associated with decreased aggressive behaviors and externalizing problems scores.

LIMITATIONS: Children's behavioral development was assessed by main caregivers and might cause a certain degree of bias. There might be other potential confounders that we did not take into account.

CONCLUSIONS: A high GWGR in the second trimester might be beneficial for children's cognitive and behavioral development, while a high GWGR in the third trimester might be harmful.

摘要
背景: 妊娠期体重增加率(GWGR)与儿童认知和行为发育关系的研究证据有限。

方法: 选取中国马鞍山出生队列的3273对单胎活产母婴。产妇GWGR是根据多次产前检查测量的体重来计算的。采用中文版韦氏学前和小学智力量表(第四版)和Achenbach儿童行为量表(1.5-5)对儿童的认知和行为发展进行评估。然后采用广义线性模型进行分析。

结果: 在儿童认知发展方面，妊娠中期GWGR过高与视觉空间指数(VSI)、流体推理指数(FRI)和全量表智商(FSIQ)得分升高有关，妊娠晚期GWGR过高与VSI、工作记忆指数(WMI)和FSIQ得分下降有关。在儿童行为发展方面，孕中期GWGR过高与攻击行为和外化问题得分降低有关。

局限性: 儿童的行为发展是由主要照顾者评估的，可能会造成一定程度的偏差。可能还有其他我们没有考虑到的潜在混杂因素。

结论: 妊娠中期高GWGR可能有利于儿童的认知和行为发育，而妊娠晚期高GWGR可能有害。