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母亲产前心理困扰和维生素摄入与儿童神经认知发育的关系。

Maternal prenatal psychological distress and vitamin intake with children's neurocognitive development.

机构信息

Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.

Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.

出版信息

Pediatr Res. 2022 Nov;92(5):1450-1457. doi: 10.1038/s41390-022-02003-0. Epub 2022 Mar 14.

Abstract

BACKGROUND

Maternal prenatal psychological distress (PPD) is increasingly linked to sub-optimal child neurodevelopment. Daily intake of prenatal vitamin during pre-conception and early pregnancy may ameliorate the effects of PPD on cognition in the offspring.

METHODS

PPD was assessed in early (12-16 weeks) and late (28-32 weeks) gestation in the Ontario Birth Study. Prenatal vitamin supplement intake information was collected in early gestation. Child cognition at 4 years was assessed using the NIH Toolbox. Poisson regression was used to investigate associations between PPD and/or prenatal vitamin intake and child cognition.

RESULTS

Four hundred and eighteen mother-child dyads were assessed. Moderate-severe PPD experienced during early gestation was associated with reduced cognition (adjusted incidence rate ratio (IRR) = 3.71, 95% confidence interval (CI): 1.57-8.77, P = 0.003). Daily intake of prenatal vitamins was not associated with cognition (IRR = 1.34, 95% CI: 0.73-2.46, P = 0.34). Upon stratification, the experience of mild-severe PPD with daily intake of prenatal vitamins was associated with higher incident rates of suboptimal cognition compared to children of women with daily prenatal vitamin intake without any episode of PPD (IRR = 2.88, 95% CI: 1.1-7.4).

CONCLUSIONS

Moderate-severe PPD in early pregnancy is associated with poor cognition in children and daily intake of prenatal vitamin did not ameliorate this association.

IMPACT

Our findings expand on existing literature by highlighting that exposure to prenatal psychological distress (PPD), in moderate-to-severe form, in the early stages of pregnancy, can have detrimental effects on the offspring's cognitive development at 4 years. Overall, prenatal vitamin intake did not ameliorate the effects of PPD. Early screening and treatment of prenatal maternal mental illness is crucial.

摘要

背景

母体产前心理困扰(PPD)与儿童神经发育不良的相关性日益增加。在受孕前和孕早期每天摄入产前维生素可能会减轻 PPD 对后代认知的影响。

方法

在安大略出生研究中,在妊娠早期(12-16 周)和妊娠晚期(28-32 周)评估 PPD。在妊娠早期收集产前维生素补充剂摄入信息。使用 NIH 工具包评估儿童 4 岁时的认知能力。使用泊松回归分析 PPD 和/或产前维生素摄入与儿童认知之间的关联。

结果

评估了 418 对母婴对子。妊娠早期经历中度至重度 PPD 与认知能力下降有关(调整后的发病率比(IRR)=3.71,95%置信区间(CI):1.57-8.77,P=0.003)。每天摄入产前维生素与认知能力无关(IRR=1.34,95%CI:0.73-2.46,P=0.34)。分层后,与无任何 PPD 发作的女性每日摄入产前维生素的儿童相比,经历轻度至重度 PPD 且每日摄入产前维生素的儿童发生认知功能不良的发生率更高(IRR=2.88,95%CI:1.1-7.4)。

结论

妊娠早期中度至重度 PPD 与儿童认知能力差有关,而每日摄入产前维生素并不能改善这种关联。

影响

我们的研究结果扩展了现有文献,强调了在妊娠早期,中等至重度 PPD 的暴露会对儿童 4 岁时的认知发育产生不利影响。总体而言,产前维生素的摄入并没有减轻 PPD 的影响。早期筛查和治疗产前母亲的精神疾病至关重要。

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