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患有饮食失调症的母亲所生婴儿的神经行为和认知发展。

Neurobehavioural and cognitive development in infants born to mothers with eating disorders.

作者信息

Barona Manuela, Taborelli Emma, Corfield Freya, Pawlby Susan, Easter Abigail, Schmidt Ulrike, Treasure Janet, Micali Nadia

机构信息

Institute of Child Health, UCL, London, UK.

Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK.

出版信息

J Child Psychol Psychiatry. 2017 Aug;58(8):931-938. doi: 10.1111/jcpp.12736. Epub 2017 Apr 28.

Abstract

INTRODUCTION

Although recent research has focused on the effects of maternal eating disorders (EDs) on children, little is known about the effect of maternal EDs on neurobiological outcomes in newborns and infants. This study is the first to investigate neurobehavioural regulation and cognitive development in newborns and infants of mothers with EDs.

METHODS

Women with an active and past ED and healthy controls were recruited to a prospective longitudinal study during their first trimester or second trimester of pregnancy. Newborns and infants of mothers with ED were compared with newborns and infants of healthy controls on (a) neurobehavioural dysregulation using the Brazelton Neonatal Behavioural Assessment Scale at 8 days postpartum (active ED, n = 15; past ED, n = 20; healthy controls, n = 28); and (b) cognitive development using the Bayley Scales of Infant and Toddler Development at 1-year postpartum (active ED, n = 18; past ED, n = 19; healthy controls, n = 28). In order to maintain the largest possible sample at each time point, sample size varied across time points.

RESULTS

Newborns of mothers with an active ED had worse autonomic stability when compared with newborns of healthy controls [B = -0.34 (-1.81, -0.26)]. Infants of mothers with a past ED had poorer language [B = -0.33 (-13.6, -1.9)] and motor development [B = -0.32 (-18.4, -1.3)] compared with healthy controls.

CONCLUSIONS

Children of mothers with ED display neurobehavioural dysregulation early after birth and poorer language and motor development at 1 year. These characteristics suggest evidence of early neurobiological markers in children at risk. Differential outcomes in children of women with active versus past ED suggest that active symptomatology during pregnancy might have an effect on physiological reactivity while cognitive characteristics might be more stable markers of risk for ED.

摘要

引言

尽管近期研究聚焦于母亲饮食失调对儿童的影响,但对于母亲饮食失调对新生儿和婴儿神经生物学结果的影响却知之甚少。本研究首次调查了患有饮食失调症母亲的新生儿和婴儿的神经行为调节及认知发展情况。

方法

招募患有现患和既往饮食失调症的女性以及健康对照者,在她们怀孕的头三个月或第二个三个月期间参与一项前瞻性纵向研究。将患有饮食失调症母亲的新生儿和婴儿与健康对照者的新生儿和婴儿在以下方面进行比较:(a)产后8天时使用布雷泽尔顿新生儿行为评估量表评估神经行为失调情况(现患饮食失调症组,n = 15;既往饮食失调症组,n = 20;健康对照组,n = 28);(b)产后1年时使用贝利婴幼儿发展量表评估认知发展情况(现患饮食失调症组,n = 18;既往饮食失调症组,n = 19;健康对照组,n = 28)。为了在每个时间点保持尽可能大的样本量,样本量在不同时间点有所变化。

结果

与健康对照者的新生儿相比,患有现患饮食失调症母亲的新生儿自主稳定性较差[B = -0.34(-1.81,-0.26)]。与健康对照者相比,患有既往饮食失调症母亲的婴儿语言能力较差[B = -0.33(-13.6,-1.9)],运动发育也较差[B = -0.32(-18.4,-1.3)]。

结论

患有饮食失调症母亲的孩子在出生后早期表现出神经行为失调,1岁时语言和运动发育较差。这些特征表明处于风险中的儿童存在早期神经生物学标志物的证据。现患与既往饮食失调症女性的孩子出现不同结果表明,孕期的现患症状可能对生理反应性有影响,而认知特征可能是饮食失调风险更稳定的标志物。

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