Keim Sarah A, Bodnar Lisa M, Klebanoff Mark A
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH; Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
Paediatr Perinat Epidemiol. 2014 Sep;28(5):434-44. doi: 10.1111/ppe.12135. Epub 2014 Jun 17.
Animal studies have linked in utero vitamin D exposure to various aspects of offspring brain development. Limited research has translated these findings to humans, and none have employed cord blood to measure exposure late in gestation.
Our objective was to examine the associations between maternal 25(OH)D measured at ≤26 weeks' gestation or cord blood 25(OH)D and offspring global development, IQ, achievement, and behaviour in the US Collaborative Perinatal Project (1959-73). This was a secondary analysis of data from a case-cohort study, with 3896 women and children who participated in at least one outcome assessment. Psychologists assessed global development at 8 months, IQ and behaviour at 4 and 7 years, and achievement at 7 years. Multiple linear and logistic regression was used to examine the associations between 25(OH)D and child outcomes, controlling for maternal education, age, parity, race, maternal body mass index, marital status, smoking, gestational age and month of blood draw, and study site.
Positive associations for many outcomes were greatly attenuated upon adjustment for confounders and were generally null. Only IQ at age 7 was associated with both maternal and cord blood 25(OH)D, but the effect estimates were very small (β for 5 nmol/L increment of maternal 25(OH)D = 0.10; [95% CI 0.00, 0.19]).
We observed very little indication that maternal or cord blood 25(OH)D are associated with cognitive development, achievement, and behaviour between 8 months and 7 years of age.
动物研究已将子宫内维生素D暴露与后代大脑发育的各个方面联系起来。将这些发现转化到人类中的研究有限,且尚无研究采用脐带血来测量妊娠晚期的暴露情况。
我们的目标是在美国围产期协作项目(1959 - 1973年)中,研究妊娠≤26周时测量的母体25(OH)D或脐带血25(OH)D与后代整体发育、智商、学业成绩和行为之间的关联。这是一项对病例队列研究数据的二次分析,有3896名妇女和儿童至少参与了一项结局评估。心理学家在8个月时评估整体发育,在4岁和7岁时评估智商和行为,在7岁时评估学业成绩。采用多元线性和逻辑回归来研究25(OH)D与儿童结局之间的关联,并对母体教育程度、年龄、产次、种族、母体体重指数、婚姻状况、吸烟情况、孕周和采血月份以及研究地点进行了控制。
在对混杂因素进行调整后,许多结局的正相关关系大幅减弱,总体上无显著关联。只有7岁时的智商与母体和脐带血25(OH)D均有关联,但效应估计值非常小(母体25(OH)D每增加5 nmol/L,β = 0.10;[95%置信区间0.00, 0.19])。
我们几乎没有观察到证据表明母体或脐带血25(OH)D与8个月至7岁儿童的认知发育、学业成绩和行为有关联。