Li Qiong, Wang Haixia, Yang Qiaolan, Zhang Lei, Dai Feicai, Yu Lijun, Wu Lin, Ge Jinfang, Zhu Peng
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.
Prev Med Rep. 2024 Jan 3;38:102586. doi: 10.1016/j.pmedr.2024.102586. eCollection 2024 Feb.
We investigate the prospective the association of gestational cardiovascular health (CVH) with infant neurodevelopment, and whether such relation was mediated by cord blood metabolites. The data come from the prospective birth cohort study in Hefei of Anhui, China. A total of 1714 mother-infant pairs are included from March 2018 and June 2021. CVH was evaluated at 24 to 28 gestational weeks by the combination of five metrics: body mass index, blood pressure, total cholesterol, glucose, and smoking. Cord blood samples were collected at delivery for the detection of related indicators. Infant neurodevelopment at 12 months was assessed by the Ages and Stages Questionnaire Edition 3 (ASQ-3). We stratified the status of CVH into three levels, ideal, intermediate, and poor. Compared with the ideal CVH, poor CVH was associated with infant communication domain failure (RR = 2.06; 95 %CI, 1.24-3.42) and cord blood C-peptide levels (β = 0.09; 95 %CI, 0.06-0.13) were higher. Cord blood C-peptide level with infant communication domain failure risk increased (RR = 3.43, 95 %CI: 2.11-5.58). Mediation analysis showed that cord blood C-peptide mediated 13.9 % of the effect. Key findings indicated that maternal poor CVH at 24 to 28 weeks gestation was associated with an increased risk of infant neurodevelopment at ASQ-3 failure in the communication domain, and cord blood C-peptide might mediate this association. The findings, if confirmed by replications, specific nursing cares among pregnant women with poor CVH, might have implications for the offspring neurodevelopment prevention strategies targeting.
我们研究了妊娠期心血管健康(CVH)与婴儿神经发育的前瞻性关联,以及这种关系是否由脐带血代谢物介导。数据来自中国安徽合肥的前瞻性出生队列研究。2018年3月至2021年6月共纳入1714对母婴。在妊娠24至28周时,通过体重指数、血压、总胆固醇、血糖和吸烟这五个指标的组合来评估CVH。分娩时采集脐带血样本以检测相关指标。12个月时婴儿的神经发育通过《年龄与发育阶段问卷第3版》(ASQ - 3)进行评估。我们将CVH状态分为理想、中等和差三个水平。与理想CVH相比,差的CVH与婴儿沟通领域发育迟缓相关(相对风险RR = 2.06;95%置信区间CI,1.24 - 3.42),且脐带血C肽水平更高(β = 0.09;95%CI,0.06 - 0.13)。脐带血C肽水平升高会增加婴儿沟通领域发育迟缓的风险(RR = 3.43,95%CI:2.11 - 5.58)。中介分析表明,脐带血C肽介导了13.9%的效应。主要研究结果表明,妊娠24至28周时母亲CVH差与婴儿在ASQ - 3沟通领域发育迟缓风险增加相关,且脐带血C肽可能介导这种关联。这些研究结果若能被重复验证,对于CVH差的孕妇进行特定护理,可能对针对后代神经发育的预防策略具有启示意义。