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有饮食障碍病史的母亲所生婴儿的头围生长和神经认知发育迟缓:纵向队列研究。

Retarded head growth and neurocognitive development in infants of mothers with a history of eating disorders: longitudinal cohort study.

机构信息

Department of Women's and Children's Health, Division for Obstetrics and Gynaecology, Karolinska Institutet and University Hospital, Stockholm, Sweden.

出版信息

BJOG. 2013 Oct;120(11):1413-22. doi: 10.1111/1471-0528.12370. Epub 2013 Jul 3.

Abstract

OBJECTIVE

To characterise early growth and neurocognitive development in children of mothers with a history of eating disorders (ED).

DESIGN

A longitudinal cohort study.

SETTING

Child-care centres in Stockholm, Sweden.

POPULATION

Children born to mothers with previous ED (n = 47) (24 anorexia nervosa, 20 bulimia nervosa, 3 unspecified ED), and controls (n = 65).

METHODS

Mean values and standard deviation scores of weight and height from birth to 5 years of age and head circumference up to 18 months of age were compared between groups. Neurocognitive development was studied at the age of 5 years by the validated parent questionnaire Five to Fifteen.

MAIN OUTCOME MEASURES

Head growth and neurocognitive development.

RESULTS

We previously reported that mothers with a history of ED conceived infants with lower birthweight and head circumference than controls. At 3 months of age, body mass index (BMI) was no longer reduced but mean head circumferences of the children born to mothers with ED were smaller throughout the observation period. Similarly, the longitudinal results of the standard deviation scores of head circumference showed a significant overall group effect with lower levels in both subgroups of ED (anorexia nervosa and bulimia nervosa). The children of the ED mothers also had significantly higher Five to Fifteen scores than controls, reflecting difficulties in language skills. Head circumference at birth correlated with language skills in the children of mothers with ED.

CONCLUSION

Children of mothers with previous ED demonstrated an early catch-up in BMI, but the average head circumference continued to be delayed until at least 18 months of age. The reduced head growth was related to delayed neurocognitive development.

摘要

目的

描述有饮食障碍(ED)病史的母亲所生儿童的早期生长和神经认知发育情况。

设计

纵向队列研究。

地点

瑞典斯德哥尔摩的儿童保健中心。

人群

有既往 ED 病史的母亲所生的儿童(n=47)(24 例神经性厌食症,20 例神经性贪食症,3 例未特指 ED)和对照组(n=65)。

方法

比较两组儿童从出生到 5 岁时的体重和身高的平均值和标准差评分以及 18 个月时的头围。在 5 岁时,使用经过验证的父母问卷 Five to Fifteen 研究神经认知发育。

主要观察指标

头围生长和神经认知发育。

结果

我们之前报告称,有 ED 病史的母亲所生婴儿的出生体重和头围低于对照组。在 3 个月时,体重指数(BMI)不再降低,但 ED 母亲所生孩子的头围平均值在整个观察期内仍然较小。同样,头围标准差评分的纵向结果显示存在显著的总体组效应,ED 的两个亚组(神经性厌食症和神经性贪食症)的水平均较低。ED 母亲的孩子在 Five to Fifteen 评分上也显著高于对照组,反映出语言技能方面存在困难。ED 母亲的孩子出生时的头围与 ED 母亲的孩子的语言技能相关。

结论

有 ED 病史母亲的孩子的 BMI 早期出现追赶生长,但平均头围直到至少 18 个月仍持续延迟。头围生长受限与神经认知发育延迟有关。

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