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出生时的体型与晚年认知能力:系统综述。

Size at birth and cognitive ability in late life: A systematic review.

机构信息

Department of Research, Foundation for Research and Advocacy in Mental Health (FRAMe), Mysore, India.

Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India.

出版信息

Int J Geriatr Psychiatry. 2019 Aug;34(8):1139-1169. doi: 10.1002/gps.5138. Epub 2019 Jun 13.

Abstract

INTRODUCTION

Recent evidence suggests that growth restriction in utero may lead to neurocognitive disorders in late life, either through impaired brain development or adverse metabolic programming.

METHODS

Systematic review of literature investigating the relationship between size at birth and cognitive abilities in late life. The search, data extraction, and rating for the quality of reporting were conducted independently by two researchers.

RESULTS

Of 533 selected studies, 11 were included in this systematic review and 10 of these were from high-income setting. Of these 11 studies, eight indicated that lower birth weight is a risk factor for lower cognitive function in late life, at least in high-income countries. The reported effect sizes were small and it was not possible to conduct meta-analyses because of clinical heterogeneity DISCUSSION: A modest association of lower birth weight with lower cognitive abilities in late life is consistent with persisting effects of the prenatal environment on brain function. As with all observational studies, confounding is an alternative explanation. Further studies are required to elucidate the mechanisms.

摘要

引言

最近的证据表明,宫内生长受限可能会导致晚年的神经认知障碍,这可能是通过大脑发育受损或代谢编程不良导致的。

方法

系统地回顾了研究出生时大小与晚年认知能力之间关系的文献。由两名研究人员独立进行了检索、数据提取和报告质量评估。

结果

在 533 篇选定的研究中,有 11 篇被纳入了这项系统综述,其中 10 篇来自高收入国家。在这 11 项研究中,有 8 项表明,较低的出生体重是晚年认知功能较低的一个危险因素,至少在高收入国家是如此。报告的效应量很小,由于临床异质性,无法进行荟萃分析。

讨论

出生体重较低与晚年认知能力较低之间存在适度的关联,这与产前环境对大脑功能的持续影响是一致的。与所有观察性研究一样,混杂因素是另一种解释。需要进一步的研究来阐明这些机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e34b/6771720/400da497e7d3/GPS-34-1139-g001.jpg

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