Melfald Tveten Kine, Miodini Nilsen Roy, Dragesund Tove
Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
Front Pediatr. 2022 Apr 5;10:789158. doi: 10.3389/fped.2022.789158. eCollection 2022.
The preventive effect of maternal folic acid use on offspring neural tube defects is well-established. However, a putative link between supplement use and other neurodevelopmental outcome is inconsistent. The aim of this study was to examine the association of folic acid-containing supplement use before and during pregnancy with motor function in children aged 3-18 months.
The study has a prospective cohort design including 503 mother-infant dyads. Motor function was measured by the Infant Motor Profile (IMP) and Ages and Stages Questionnaire Second Edition (ASQ-2). Associations between exposure and outcome were examined using linear regression analysis with robust standard error estimation.
Offspring total IMP score was not associated with any maternal folic acid-containing supplement use when they were used during pregnancy only (adjusted β = 0.11 95% CI = -1.19, 1.40; = 0.87) or when they were used both before and during pregnancy (adjusted β = 0.22 95% CI = -0.95, 1.40; = 0.70). When examining the five domain scores separately, only the IMP domain adaptability showed some association with supplement use during pregnancy (adjusted β = 2.87; 95% CI = 0.08, 5.68; = 0.04), but the strength of the association was weak. Further, supplement use was not associated with any of the two motor domains of ASQ-2.
Although no association between folic acid-containing supplement use and offspring motor function was found, the complexity of this topic and its potential mechanisms, requires further investigation. This research should include robust and accurate measures on maternal nutritional status along with thorough endpoint assessments.
母亲使用叶酸对后代神经管缺陷的预防作用已得到充分证实。然而，补充剂使用与其他神经发育结局之间的假定联系并不一致。本研究的目的是探讨孕期及孕前使用含叶酸补充剂与3至18个月儿童运动功能之间的关联。
本研究采用前瞻性队列设计，纳入503对母婴。运动功能通过婴儿运动量表（IMP）和年龄与阶段问卷第二版（ASQ-2）进行测量。使用稳健标准误差估计的线性回归分析来检验暴露与结局之间的关联。
仅在孕期使用含叶酸补充剂时（调整后β = 0.11，95%置信区间 = -1.19，1.40；P = 0.87）或在孕前及孕期均使用时（调整后β = 0.22，95%置信区间 = -0.95，1.40；P = 0.70），后代IMP总分与母亲使用含叶酸补充剂均无关联。分别检查五个领域得分时，只有IMP领域适应性与孕期补充剂使用有一定关联（调整后β = 2.87；95%置信区间 = 0.08，5.68；P = 0.04），但关联强度较弱。此外，补充剂使用与ASQ-2的两个运动领域均无关联。
虽然未发现含叶酸补充剂使用与后代运动功能之间存在关联，但该主题的复杂性及其潜在机制需要进一步研究。这项研究应包括对母亲营养状况的可靠准确测量以及全面的终点评估。
