产前补充微量营养素与学龄儿童早期智力发育无关。

Prenatal Micronutrient Supplementation Is Not Associated with Intellectual Development of Young School-Aged Children.

作者信息

Li Chao, Zeng Lingxia, Wang Duolao, Yang Wenfang, Dang Shaonong, Zhou Jing, Yan Hong

机构信息

Department of Epidemiology and Biostatistics, School of Public Health.

Department of Clinical Sciences, Liverpool School of Tropical Medicine Pembroke Place, Liverpool, United Kingdom; and.

出版信息

J Nutr. 2015 Aug;145(8):1844-9. doi: 10.3945/jn.114.207795. Epub 2015 Jun 17.

DOI:10.3945/jn.114.207795

PMID:26084366

Abstract

BACKGROUND

Micronutrient supplementation is often prescribed during pregnancy. The effects of prenatal iron and multimicronutrient supplementation on intellectual development in young school-aged children are less than clear.

OBJECTIVE

The aim of this study was to examine the long-term effects of prenatal iron plus folic acid or multiple micronutrient (including iron and folic acid) supplementation vs. folic acid supplementation on the intellectual development of young school-aged children in rural China.

METHODS

Young school-aged children (aged 7-10 y, n = 1744) of women who had participated in a trial of prenatal supplementation with various combinations of micronutrients and remained residents in 2 rural counties in China were followed. We measured their intellectual development by Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). The WISC-IV generated the Full-Scale Intelligence Quotient (FSIQ), Verbal Comprehension Index (VCI), Working Memory Index (WMI), Perceptual Reasoning Index (PRI), and Processing Speed Index (PSI). Multilevel analyses were used to assess the effect of prenatal micronutrient supplementation on the intellectual development of children.

RESULTS

The mean differences in FSIQ, VCI, WMI, PRI, and PSI, respectively, were not significant between prenatal folic acid supplementation and either iron plus folic acid [-0.34 (P = 0.65), -0.06 (P = 0.95), -0.22 (P = 0.76), -0.01 (P = 0.99), and -1.26 (P = 0.11)] or multimicronutrient [-0.39 (P = 0.60), -0.64 (P = 0.48), 0.11 (P = 0.87), -0.43 (P = 0.59), and -0.34; (P = 0.65)] supplementation after adjusting for confounders.

CONCLUSIONS

There is no evidence to suggest a different effect on intellectual development between prenatal iron plus folic acid, multimicronutrient supplementation, and prenatal folic acid supplementation in children aged 7-10 y. This trial was registered at www.isrctn.com as ISRCTN08850194.

摘要

背景

孕期通常会开具微量营养素补充剂。产前补充铁剂和多种微量营养素对学龄期儿童智力发育的影响尚不清楚。

目的

本研究旨在探讨产前补充铁剂加叶酸或多种微量营养素（包括铁和叶酸）与补充叶酸相比，对中国农村学龄期儿童智力发育的长期影响。

方法

对参与产前微量营养素不同组合补充试验且仍居住在中国两个农村县的妇女所生育的学龄期儿童（7 - 10岁，n = 1744）进行随访。我们使用韦氏儿童智力量表第四版（WISC - IV）测量他们的智力发育情况。WISC - IV得出全量表智商（FSIQ）、言语理解指数（VCI）、工作记忆指数（WMI）、知觉推理指数（PRI）和加工速度指数（PSI）。采用多水平分析评估产前微量营养素补充对儿童智力发育的影响。

结果

在校正混杂因素后，产前补充叶酸与补充铁剂加叶酸[-0.34（P = 0.65），-0.06（P = 0.95），-0.22（P = 0.76），-0.01（P = 0.99），-1.26（P = 0.11）]或多种微量营养素[-0.39（P = 0.60），-0.64（P = 0.48），0.11（P = 0.87），-0.43（P = 0.59），-0.34；（P = 0.65）]相比，FSIQ、VCI、WMI、PRI和PSI的平均差异均无统计学意义。