West Zoe, Demchenko Iryna, Clark Lee, White Marina, MacFarlane Amanda J, Fraser William D, Arbuckle Tye E, Connor Kristin L
Department of Health Sciences, Carleton University, Ottawa, ON, Canada.
Nutrition Research Division, Health Canada, Ottawa, ON, Canada.
J Dev Orig Health Dis. 2023 Feb;14(1):42-52. doi: 10.1017/S2040174422000228. Epub 2022 Apr 28.
Fetal and child development are shaped by early life exposures, including maternal health states, nutrition and educational and home environments. We aimed to determine if suboptimal pre-pregnancy maternal body mass index (BMI; underweight, overweight, obese) would associate with poorer cognitive outcomes in children, and whether early life nutritional, educational and home environments modify these relationships. Self-reported data were obtained from mother-infant dyads from the pan-Canadian prospective Maternal-Infant Research on Environmental Chemicals cohort. Relationships between potential risk factors (pre-pregnancy maternal BMI, breastfeeding practices and Home Observation Measurement of the Environment [HOME] score) and child cognitive development at age three (Weschler's Preschool and Primary Scale of Intelligence, Third Edition scale and its subcategories) were each evaluated using analysis of variance, multivariable regression models and moderating analyses. Amongst the 528 mother-child dyads, increasing maternal pre-pregnancy BMI was negatively associated with scores for child full-scale IQ (β [95% CI]; -2.01 [-3.43, -0.59], = 0.006), verbal composite (-1.93 [-3.33, -0.53], = 0.007), and information scale (-0.41 [-0.70, -0.14], = 0.003) scores. Higher maternal education level or HOME score attenuated the negative association between maternal pre-pregnancy BMI and child cognitive outcome by 30%-41% and 7%-22%, respectively, and accounted for approximately 5%-10% greater variation in male children's cognitive scores compared to females. Maternal education and higher quality home environment buffer the negative effect of elevated maternal pre-pregnancy BMI on child cognitive outcomes. Findings suggest that relationships between maternal, social and environmental factors must be considered to reveal pathways that shape risk for, and resiliency against, suboptimal cognitive outcomes in early life.
胎儿和儿童的发育受到早期生活经历的影响，包括母亲的健康状况、营养以及教育和家庭环境。我们旨在确定孕前母亲体重指数（BMI；体重过轻、超重、肥胖）不理想是否会与儿童较差的认知结果相关，以及早期生活中的营养、教育和家庭环境是否会改变这些关系。自我报告的数据来自全加拿大前瞻性母婴环境化学物质研究队列中的母婴二元组。使用方差分析、多变量回归模型和调节分析分别评估了潜在风险因素（孕前母亲BMI、母乳喂养方式和家庭环境观察测量[HOME]得分）与儿童三岁时认知发展（韦氏学前和小学智力量表第三版及其子类别）之间的关系。在528对母婴二元组中，母亲孕前BMI的增加与儿童全量表智商得分（β[95%置信区间]；-2.01[-3.43，-0.59]，P = 0.006）、语言综合得分（-1.93[-3.33，-0.53]，P = 0.007）和信息量表得分（-0.41[-0.70，-0.14]，P = 0.003）呈负相关。母亲教育水平较高或HOME得分较高分别使母亲孕前BMI与儿童认知结果之间的负相关减弱了30%-41%和7%-22%，并且与女性相比，男性儿童认知得分的变异解释率高出约5%-10%。母亲教育和更高质量的家庭环境缓冲了母亲孕前BMI升高对儿童认知结果的负面影响。研究结果表明，必须考虑母亲、社会和环境因素之间的关系，以揭示塑造早期生活中认知结果不理想的风险和恢复力的途径。
