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孕妇孕期叶酸水平与儿童 2 岁时神经心理发育的关系。

Maternal folate levels during pregnancy and children's neuropsychological development at 2 years of age.

机构信息

Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China.

Department of Dermatology, Children's Hospital of Fudan University, Shanghai, China.

出版信息

Eur J Clin Nutr. 2020 Nov;74(11):1585-1593. doi: 10.1038/s41430-020-0612-9. Epub 2020 Apr 2.

Abstract

OBJECTIVE

To explore the relationship between maternal folate levels during pregnancy and children's neuropsychological development at 2 years of age.

METHODS

In the birth cohort MKFOAD, maternal serum folate concentrations at 12-14, 22-26, and 34-36 weeks of gestation were measured, as well as red blood cell (RBC) folate at 12-14 weeks. Neurodevelopment of 2-year-old children was assessed by Gesell Development Scale (GDS), which contained subscales of gross motor, fine motor, language, adaptive behavior, and social behavior. Linear regression models were applied to investigate the association of maternal folate levels with children's developmental quotients (DQs).

RESULTS

One hundred and eighty singleton children participated the GDS assessment, of whom 97 (53.9%) were boys. Median RBC folate concentration was 1002.8 (IQR = 577.6) nmol L in early pregnancy and median serum folate concentrations were, respectively, 33.9 (IQR = 9.2) nmol L, 26.3 (IQR = 14.3) nmol L, and 26.7 (IQR = 18.9) nmol L. Maternal serum folate concentration in late pregnancy was significantly associated with children's language development, where language DQ increases by 3.1 (95% CI 0.6, 5.5) for every 10 nmol L increment of serum folate concentration. And maternal serum folate in early pregnancy was significantly associated with children's fine motor development, with 2.0 (95% CI 0.1, 4.0) DQ decrease for 10 nmol L increase of serum folate.

CONCLUSIONS

Maternal serum folate in late pregnancy was significantly associated with children's language development at age 2, which supports the importance of remaining folic acid supplementation across the entire gestation. However, maternal serum folate in early pregnancy was also inversely associated with children's fine motor development.

摘要

目的

探讨妊娠期间母体叶酸水平与 2 岁儿童神经心理发育的关系。

方法

在出生队列 MKFOAD 中,测量了孕妇妊娠 12-14、22-26 和 34-36 周时的血清叶酸浓度,以及妊娠 12-14 周时的红细胞(RBC)叶酸浓度。采用盖塞尔发育量表(GDS)评估 2 岁儿童的神经发育情况,GDS 包含大运动、精细运动、语言、适应行为和社会行为等分量表。采用线性回归模型探讨母体叶酸水平与儿童发育商(DQ)的关系。

结果

共有 180 名单胎儿童接受了 GDS 评估,其中 97 名(53.9%)为男孩。妊娠早期 RBC 叶酸浓度中位数为 1002.8(IQR=577.6)nmol/L,血清叶酸浓度中位数分别为 33.9(IQR=9.2)nmol/L、26.3(IQR=14.3)nmol/L 和 26.7(IQR=18.9)nmol/L。妊娠晚期血清叶酸浓度与儿童语言发育显著相关,血清叶酸浓度每增加 10 nmol/L,语言 DQ 增加 3.1(95%CI:0.6,5.5)。妊娠早期血清叶酸浓度与儿童精细运动发育显著相关,血清叶酸浓度增加 10 nmol/L,儿童精细运动 DQ 下降 2.0(95%CI:0.1,4.0)。

结论

妊娠晚期血清叶酸水平与 2 岁儿童语言发育显著相关,这支持了在整个孕期持续补充叶酸的重要性。然而,妊娠早期血清叶酸也与儿童精细运动发育呈负相关。

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