Belfort Mandy B, Rifas-Shiman Sheryl L, Rich-Edwards Janet W, Kleinman Ken P, Oken Emily, Gillman Matthew W
Children's Hospital Boston, Division of Newborn Medicine, Hunnewell 437, 300 Longwood Ave, Boston, MA 02115, USA.
Pediatrics. 2008 Sep;122(3):e689-95. doi: 10.1542/peds.2008-0500.
Infancy is a critical period for brain development. Few studies have examined the extent to which infant weight gain is associated with later neurodevelopmental outcomes in healthy populations.
The purpose of this work was to examine associations of infant weight gain from birth to 6 months with child cognitive and visual-motor skills at 3 years of age.
We studied 872 participants in Project Viva, an ongoing prospective, longitudinal, prebirth cohort. We abstracted birth weight from the medical chart and weighed infants at 6 months of age. We used the 2000 Centers for Disease Control and Prevention growth charts to derive weight-for-age z scores. Our primary predictor was infant weight gain, defined as the weight-for-age z score at 6 months adjusted for the weight-for-age z score at birth. At 3 years of age, we measured child cognition with the Peabody Picture Vocabulary Test III and visual-motor skills with the Wide Range Assessment of Visual Motor Abilities.
Mean Peabody Picture Vocabulary Test III score was 104.2, and mean Wide Range Assessment of Visual Motor Abilities test score was 102.8. Mean birth weight z score was 0.21, and mean 6-month weight z score was 0.39. In multiple linear regression adjusted for child age, gender, gestational age, breastfeeding duration, primary language, and race/ethnicity; maternal age, parity, smoking status, and cognition; and parental education and income level, we found no association of infant weight gain with child Peabody Picture Vocabulary Test III score (-0.4 points per z score weight gain increment, 95% confidence interval -1.3, 0.6) or total Wide Range Assessment of Visual Motor Abilities standard score (-0.4 points, 95% confidence interval -1.2, 0.5).
Slower infant weight gain was not associated with poorer neurodevelopmental outcomes in healthy, term-born 3-year-old children. These results should aid in determining optimal growth patterns in infants to balance risks and benefits of health outcomes through the life course.
婴儿期是大脑发育的关键时期。很少有研究探讨在健康人群中,婴儿体重增加与后期神经发育结果之间的关联程度。
本研究旨在探讨出生至6个月龄婴儿体重增加与3岁儿童认知和视觉运动技能之间的关联。
我们对“活力计划”中的872名参与者进行了研究,这是一项正在进行的前瞻性、纵向、产前队列研究。我们从病历中提取出生体重,并在婴儿6个月龄时进行称重。我们使用2000年美国疾病控制与预防中心的生长图表得出年龄别体重z评分。我们的主要预测指标是婴儿体重增加,定义为6个月龄时的年龄别体重z评分减去出生时的年龄别体重z评分。在3岁时,我们使用皮博迪图片词汇测试第三版测量儿童认知能力,使用视觉运动能力广泛评估测试测量视觉运动技能。
皮博迪图片词汇测试第三版的平均得分为104.2分,视觉运动能力广泛评估测试的平均得分为102.8分。出生体重z评分的平均值为0.21,6个月龄体重z评分的平均值为0.39。在对儿童年龄、性别、胎龄、母乳喂养时间、主要语言和种族/族裔;母亲年龄、产次、吸烟状况和认知能力;以及父母教育程度和收入水平进行多线性回归调整后,我们发现婴儿体重增加与儿童皮博迪图片词汇测试第三版得分(每增加一个z评分体重增加,得分降低0.4分,95%置信区间为-1.3至0.6)或视觉运动能力广泛评估测试总标准得分(降低0.4分,95%置信区间为-1.2至0.5)之间无关联。
在健康的足月出生3岁儿童中,婴儿体重增加较慢与较差的神经发育结果无关。这些结果应有助于确定婴儿的最佳生长模式,以平衡一生中健康结果的风险和益处。