脐带血睾酮水平与儿童早期语言发育迟缓的性别特异性关联。
Sex-specific associations between umbilical cord blood testosterone levels and language delay in early childhood.
机构信息
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, WA 6008, Australia.
出版信息
J Child Psychol Psychiatry. 2012 Jul;53(7):726-34. doi: 10.1111/j.1469-7610.2011.02523.x. Epub 2012 Jan 26.
BACKGROUND
Preliminary evidence suggests that prenatal testosterone exposure may be associated with language delay. However, no study has examined a large sample of children at multiple time-points.
METHODS
Umbilical cord blood samples were obtained at 861 births and analysed for bioavailable testosterone (BioT) concentrations. When participating offspring were 1, 2 and 3 years of age, parents of 767 children (males = 395; females = 372) completed the Infant Monitoring Questionnaire (IMQ), which measures Communication, Gross Motor, Fine Motor, Adaptive and Personal-Social development. Cut-off scores are available for each scale at each age to identify children with 'clinically significant' developmental delays. Chi-square analyses and generalized estimating equations examined longitudinal associations between sex-specific quartiles of BioT concentrations and the rate of developmental delay.
RESULTS
Significantly more males than females had language delay (Communication scale) at age 1, 2 and 3 years (p-values ≤. 01). Males were also more likely to be classified as delayed on the Fine-Motor (p = .04) and Personal-Social (p < .01) scales at age 3 years. Chi-square analyses found a significant difference between BioT quartiles in the rate of language delay (but not Fine-Motor and Personal-Social delay) for males (age 3) and females (age 1 and 3). Generalized estimating equations, incorporating a range of sociodemographic and obstetric variables, found that males in the highest BioT quartile were at increased risk for a clinically significant language delay during the first 3 years of life, with an odds ratio (OR) of 2.47 (95% CI: 1.12, 5.47). By contrast, increasing levels of BioT reduced the risk of language delay among females (Quartile 2: OR = 0.23, 95% CI: 0.09, 0.59; Quartile 4: 0.46, 95% CI: 0.21, 0.99).
CONCLUSION
These data suggest that high prenatal testosterone levels are a risk factor for language delay in males, but may be a protective factor for females.
背景
初步证据表明，产前睾酮暴露可能与语言延迟有关。然而，尚无研究在多个时间点检查大量儿童样本。
方法
在 861 例分娩时采集脐带血样，分析可利用的睾酮（BioT）浓度。当参与的后代为 1、2 和 3 岁时，767 名儿童的父母（男 395 名，女 372 名）完成了婴儿监测问卷（IMQ），该问卷测量沟通、大运动、精细运动、适应和个人-社会发展。每个年龄的每个量表都有临界分数，用于识别有“临床显著”发育迟缓的儿童。卡方分析和广义估计方程检查了 BioT 浓度性别特异性四分位数与发育迟缓速度之间的纵向关联。
结果
1、2 和 3 岁时，语言延迟（沟通量表）的男性明显多于女性（p 值≤.01）。3 岁时，男性在精细运动（p=0.04）和个人-社会（p<0.01）量表上也更有可能被归类为延迟。卡方分析发现，BioT 四分位组在男性（3 岁）和女性（1 岁和 3 岁）的语言延迟率（但不是精细运动和个人-社会延迟率）之间存在显著差异。广义估计方程，纳入了一系列社会人口统计学和产科变量，发现 BioT 四分位最高的男性在生命的头 3 年有较高的临床显著语言延迟风险，优势比（OR）为 2.47（95%CI：1.12，5.47）。相比之下，BioT 水平升高降低了女性语言延迟的风险（四分位 2：OR=0.23，95%CI：0.09，0.59；四分位 4：0.46，95%CI：0.21，0.99）。
结论
这些数据表明，产前高睾酮水平是男性语言延迟的危险因素，但可能是女性的保护因素。
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