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参与一项随机对照试验的女性后代的早期神经发育情况,该试验评估营养加运动干预对12个月大婴儿认知发育的有效性。

Early neurodevelopment in the offspring of women enrolled in a randomized controlled trial assessing the effectiveness of a nutrition + exercise intervention on the cognitive development of 12-month-olds.

作者信息

Mortaji Neda, Krzeczkowski John, Atkinson Stephanie, Amani Bahar, Schmidt Louis A, Van Lieshout Ryan J

机构信息

Neuroscience Graduate Program, McMaster University, Hamilton, Canada.

Department of Health Sciences, Brock University, Toronto, Canada.

出版信息

J Dev Orig Health Dis. 2023 Aug;14(4):532-539. doi: 10.1017/S204017442300020X. Epub 2023 Jul 14.

Abstract

Experimental data on the effects of lifestyle interventions on fetal neurodevelopment in humans remain scarce. This study assessed the impact of a pregnancy nutrition+exercise intervention on offspring neurodevelopment at 12 months of age. The Be Healthy in Pregnancy (BHIP) randomized controlled trial (RCT) randomly assigned pregnant persons with stratification by site and body mass index (BMI) to bi-weekly nutrition counselling and high dairy protein diet, walking goal of 10,000 steps/day plus usual prenatal care (UPC; intervention group) or UPC alone (control group). This study examined a subset of these mothers (> 18 years, singleton pregnancy, BMI <40 kg/m, and enrolled by ≤12 weeks gestation) and their infants (intervention = 42, control = 32), assessing cognition, language, motor, social-emotional, and adaptive functioning at 12 months using the third edition (BSID-III) as the outcome measure. We also examined if maternal factors (prepregnancy BMI, gestational weight gain (GWG)) moderated associations. Expressive language (MD = 9.62, 95% CI = (9.05-10.18), = 0.03, ƞ = 0.07) and general adaptive composite (GAC) scores (MD = 103.97, 95% CI = (100.31-107.63), = 0.04, ƞ = 0.06) were higher in infants of mothers in the intervention group. Effect sizes were medium. However, mean cognitive, receptive language, motor, and social-emotional scale scores did not differ between groups. A structured and monitored nutrition+exercise intervention during pregnancy led to improved expressive language and general adaptive behavior in 12-month-olds, but not cognitive, receptive language, motor, or socioemotional functioning. While these experimental data are promising, further research is needed to determine the clinical utility of nutrition+exercise interventions for optimizing infant neurodevelopment.

摘要

关于生活方式干预对人类胎儿神经发育影响的实验数据仍然匮乏。本研究评估了孕期营养加运动干预对12月龄后代神经发育的影响。“孕期保持健康”(BHIP)随机对照试验(RCT)将按地点和体重指数(BMI)分层的孕妇随机分为两组,一组接受每两周一次的营养咨询和高乳制品蛋白饮食,每日步行目标为10000步加常规产前护理(UPC;干预组),另一组仅接受常规产前护理(对照组)。本研究考察了这些母亲中的一个子集(年龄>18岁、单胎妊娠、BMI<40kg/m²且妊娠12周及以内入组)及其婴儿(干预组=42例,对照组=32例),使用第三版《贝利婴幼儿发展量表》(BSID-III)作为结局指标评估12个月时的认知、语言、运动、社会情感和适应性功能。我们还考察了母亲因素(孕前BMI、孕期体重增加(GWG))是否调节了相关性。干预组母亲的婴儿在表达性语言(MD = 9.62,95%CI =(9.05 - 10.18),p = 0.03,η = 0.07)和一般适应性综合(GAC)评分(MD = 103.97,95%CI =(100.31 - 107.63),p = 0.04,η = 0.06)方面更高。效应量为中等。然而,两组之间的平均认知、接受性语言、运动和社会情感量表评分没有差异。孕期进行结构化且受监测的营养加运动干预可改善12月龄婴儿的表达性语言和一般适应性行为,但对认知、接受性语言、运动或社会情感功能无改善。虽然这些实验数据很有前景,但仍需要进一步研究以确定营养加运动干预对优化婴儿神经发育的临床效用。

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