Shao S S, Huang K, Yan S Q, Zhu P, Hao J H, Tao F B
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University/MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China.
Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, Anhui Province, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2021 Feb 6;55(2):177-183. doi: 10.3760/cma.j.cn112150-20200713-00998.
To investigate the influence and critical period of pregnancy-related anxiety during pregnancy on the neurobehavioral development of infants. The subjects of this study were derived from the Ma'anshan Birth Corhot. From May 2013 to September 2014, a total of 3 474 pregnant women who registered in Ma 'anshan Maternal and Child Health Care Center were enrolled in the study. A total of 2 242 mother-infant pairs who completed three times assessments of maternal anxiety and at least once assessment of infants' neurobehavioral development were included in the final analysis. Maternal pregnancy-related anxiety was assessed by the Pregnancy-Related Anxiety Questionnaire during the first, second and third trimesters of pregnancy. When their children were at 6 and 18 months, their neurobehavioral development was evaluated using the Ages & Stages Questionnaire-China. The influence of maternal pregnancy-related anxiety on the neurobehavioral development of infants was analyzed by bi-nominal logistic regression. The age of 2 242 pregnant women was (26.62±3.65) years, and the proportion of boys, low birth weight and exclusive breastfeeding for 6 months was 50% (1 120/2 242), 1.7% (38/2 242) and 11.5% (252/2 191), respectively. The detection rates of pregnancy-related anxiety during the first, second and third trimester were 24.9% (558), 28.6% (642) and 30.3% (674), respectively. After controlling confounding variables and other two trimester's anxiety, only pregnancy-related anxiety during the third trimester (not first or second trimester) significantly increased the risk of developmental delay in the domain of communication (relative risk, = 3.52, 95% confidence interval, : 1.89-6.58) and personal-social (=2.46, 95%: 1.10-5.49) at the 6 months of age, as well as in the domain of fine motor (=2.07, 95%: 1.11-3.85), problem-solving domains (=2.31, 95%: 1.24-4.31). Maternal pregnancy-related anxiety was associated with the risk of neurobehavioral development of infants, and the third trimester may be the critical period.
探讨孕期与妊娠相关焦虑对婴儿神经行为发育的影响及关键时期。本研究对象来源于马鞍山市出生队列。2013年5月至2014年9月，共有3474名在马鞍山市妇幼保健院登记的孕妇纳入研究。最终分析纳入了2242对母婴，这些母婴完成了三次母亲焦虑评估以及至少一次婴儿神经行为发育评估。在妊娠的第一、第二和第三个 trimester 通过与妊娠相关焦虑问卷评估母亲与妊娠相关的焦虑。当她们的孩子6个月和18个月大时，使用《年龄与发育进程问卷 - 中国版》评估其神经行为发育。通过二项逻辑回归分析母亲与妊娠相关焦虑对婴儿神经行为发育的影响。2242名孕妇的年龄为（26.62±3.65）岁，男孩比例、低出生体重比例以及6个月纯母乳喂养比例分别为50%（1120/2242）、1.7%（38/2242）和11.5%（252/2191）。妊娠第一、第二和第三个 trimester 与妊娠相关焦虑的检出率分别为24.9%（558例）、28.6%（642例）和30.3%（674例）。在控制混杂变量和其他两个 trimester 的焦虑后，仅第三个 trimester（而非第一或第二个 trimester）与妊娠相关的焦虑显著增加了6个月大时在沟通领域（相对风险 = 3.52，95%置信区间：1.89 - 6.58）和个人社交领域（=2.46，95%：1.10 - 5.49）以及精细运动领域（=2.07，95%：1.11 - 3.85）、解决问题领域（=2.31，95%：1.24 - 4.31）发育迟缓的风险。母亲与妊娠相关焦虑与婴儿神经行为发育风险相关，第三个 trimester 可能是关键时期。
