Pugh Sarah J, Richardson Gale A, Hutcheon Jennifer A, Himes Katherine P, Brooks Maria M, Day Nancy L, Bodnar Lisa M
Department of Epidemiology and
Department of Epidemiology and Department of Psychiatry.
J Nutr. 2015 Nov;145(11):2562-9. doi: 10.3945/jn.115.215525. Epub 2015 Sep 30.
Maternal overweight and obesity affect two-thirds of women of childbearing age and may increase the risk of impaired child cognition.
Our objective was to test the hypothesis that high/low gestational weight gain (GWG) and high/low prepregnancy BMI were associated with offspring intelligence quotient (IQ) and executive function at age 10.
Mother-infant dyads (n = 763) enrolled in a birth cohort study were followed from early pregnancy to 10 y postpartum. IQ was assessed by trained examiners with the use of the Stanford Binet Intelligence Scale-4th edition. Executive function was assessed by the number of perseverative errors on the Wisconsin Card Sorting Test and time to complete Part B on the Trail Making Test. Self-reported total GWG was converted to gestational-age-standardized GWG z score. Multivariable linear regression and negative binomial regression were used to estimate independent and joint effects of GWG and BMI on outcomes while adjusting for covariates.
At enrollment, the majority of women in the Maternal Health Practices and Child Development cohort were unmarried and unemployed, and more than one-half reported their race as black. The mean ± SD GWG z score was -0.5 ± 1.8, and 27% of women had a pregravid BMI ≥ 25. The median (IQR) number of perseverative errors was 23 (17, 29), the mean ± SD time on Part B was 103 ± 42.6 s, and 44% of children had a low average IQ (≤ 89). Maternal obesity was associated with 3.2 lower IQ points (95% CI: -5.6, -0.8) and a slower time to complete the executive function scale Part B (adjusted β: 12.7 s; 95% CI: 2.8, 23 s) compared with offspring of normal-weight mothers. Offspring of mothers whose GWG was >+1 SD, compared with -1 to +1 SD, performed 15 s slower on the executive function task (95% CI: 1.8, 28 s). There was no association between GWG z score and offspring composite IQ score (adjusted β: -0.32; 95% CI: -0.72, 0.10). Prepregnancy BMI did not modify these associations.
Although GWG may be important for executive function, maternal BMI has a stronger relation than GWG to both offspring intelligence and executive function. Our findings contribute to evidence linking maternal obesity to long-term child outcomes.
孕产妇超重和肥胖影响着三分之二的育龄妇女，可能会增加儿童认知受损的风险。
我们的目的是检验以下假设，即孕期体重增加过高/过低（GWG）和孕前体重指数过高/过低与10岁后代的智商（IQ）和执行功能有关。
对纳入一项出生队列研究的母婴二元组（n = 763）从妊娠早期至产后10年进行随访。IQ由经过培训的检查人员使用斯坦福-比奈智力量表第4版进行评估。执行功能通过威斯康星卡片分类测试中的持续性错误数量以及连线测验B部分的完成时间进行评估。自我报告的总GWG被转换为孕周标准化的GWG z评分。多变量线性回归和负二项回归用于估计GWG和体重指数对结局的独立和联合效应，同时对协变量进行校正。
在入组时，孕产妇健康实践与儿童发育队列中的大多数女性未婚且失业，超过一半的人报告自己的种族为黑人。GWG z评分的均值±标准差为-0.5±1.8，27%的女性孕前体重指数≥25。持续性错误的中位数（IQR）为23（17，29），B部分的平均±标准差时间为103±42.6秒，44%的儿童智商处于低平均水平（≤89）。与体重正常母亲的后代相比，孕产妇肥胖与后代智商降低3.2分（95%CI：-5.6，-0.8）以及执行功能量表B部分完成时间延长有关（校正β：12.7秒；95%CI：2.8，23秒）。与GWG在-1至+1 SD之间的母亲的后代相比，GWG>+1 SD母亲的后代在执行功能任务上的表现慢15秒（95%CI：1.8，28秒）。GWG z评分与后代综合智商评分之间无关联（校正β：-0.32；95%CI：-0.72，0.10）。孕前体重指数并未改变这些关联。
尽管GWG可能对执行功能很重要，但孕产妇体重指数与后代智力和执行功能的关系比GWG更强。我们的研究结果为将孕产妇肥胖与儿童长期结局联系起来的证据提供了补充。
