Department of Developmental and Behavioral Pediatric & Child Primary Care/MOE-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Institute of Science and Technology for Brain-inspired intelligence, Fudan University, Shanghai, China.
BMC Med. 2020 Sep 1;18(1):228. doi: 10.1186/s12916-020-01701-y.
Two studies have suggested that severe prolonged nausea and vomiting during pregnancy is associated with emotional and behavioral problems in offspring, with smaller sample size and short-term follow-up. Moreover, little information is available on the role of the brain structure in the associations.
In a US-based cohort, the association was investigated between severe prolonged nausea and vomiting in pregnancy (extending after the second trimester and termed SNVP), psychiatric and cognitive problems, and brain morphology, from the Adolescent Brain Cognitive Development (ABCD) study, from 10,710 children aged 9-11 years. We validated the emotional including psychiatric findings using the Danish National Cohort Study with 2,092,897 participants.
SNVP was significantly associated with emotional and psychiatric problems (t = 8.89, Cohen's d = 0.172, p = 6.9 × 10) and reduced global cognitive performance (t = - 4.34, d = - 0.085, p = 1.4 × 10) in children. SNVP was associated with low cortical area and volume, especially in the cingulate cortex, precuneus, and superior medial prefrontal cortex. These lower cortical areas and volumes significantly mediated the relation between SNVP and the psychiatric and cognitive problems in children. In the Danish National Cohort, severe nausea and vomiting in pregnancy were significantly associated with increased risks of behavioral and emotional disorders in children (hazard ratio, 1.24; 95% confidence interval, 1.16-1.33).
SNVP is strongly associated with psychiatric and cognitive problems in children, with mediation by brain structure. These associations highlight the clinical importance and potential benefits of the treatment of SNVP, which could reduce the risk of psychiatric disorder in the next generation.
有两项研究表明，妊娠期间严重且持续时间较长的恶心和呕吐与后代的情绪和行为问题有关，但这些研究的样本量较小且随访时间较短。此外，关于大脑结构在这些关联中的作用的信息很少。
在美国的一项队列研究中，我们从青少年大脑认知发育（ABCD）研究中，调查了妊娠期间严重且持续时间较长的恶心和呕吐（延伸至妊娠中期后，称为 SNVP）与精神和认知问题以及大脑形态之间的关联，该研究纳入了 10710 名 9-11 岁的儿童。我们使用丹麦全国队列研究对包括精神方面的发现进行了验证，该研究共纳入了 2092897 名参与者。
SNVP 与情绪和精神问题显著相关（t=8.89，Cohen's d=0.172，p=6.9×10），并且与儿童的整体认知表现降低有关（t=-4.34，d=-0.085，p=1.4×10）。SNVP 与皮质面积和体积减少相关，尤其是扣带回、楔前叶和额上内侧前额叶皮质。这些较低的皮质面积和体积显著介导了 SNVP 与儿童精神和认知问题之间的关系。在丹麦全国队列研究中，妊娠期间严重的恶心和呕吐与儿童行为和情绪障碍的风险增加显著相关（危险比，1.24；95%置信区间，1.16-1.33）。
SNVP 与儿童的精神和认知问题密切相关，其与大脑结构之间存在中介关系。这些关联突出了治疗 SNVP 的临床重要性和潜在益处，这可能会降低下一代精神障碍的风险。
