Ministry of Education - Shanghai Key Laboratory of Children's Environmental Health & Department of Developmental and Behavioural Paediatric & Child Primary Care, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
NTU Psychology, School of Social Sciences, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
BMC Med. 2024 Jun 5;22(1):226. doi: 10.1186/s12916-024-03442-8.
BACKGROUND: Previous studies have linked adolescent motherhood to adverse neurodevelopmental outcomes in offspring, yet the sex-specific effect and underlying mechanisms remain unclear. METHODS: This study included 6952 children aged 9-11 from the Adolescent Brain Cognitive Development study. The exposed group consisted of children of mothers < 20 years at the time of birth, while the unexposed group was composed of children of mothers aged 20-35 at birth. We employed a generalized linear mixed model to investigate the associations of adolescent motherhood with cognitive, behavioral, and autistic-like traits in offspring. We applied an inverse-probability-weighted marginal structural model to examine the potential mediating factors including adverse perinatal outcomes, family conflict, and brain structure alterations. RESULTS: Our results revealed that children of adolescent mothers had significantly lower cognitive scores (β, - 2.11, 95% CI, - 2.90 to - 1.31), increased externalizing problems in male offspring (mean ratio, 1.28, 95% CI, 1.08 to 1.52), and elevated internalizing problems (mean ratio, 1.14, 95% CI, 0.99 to 1.33) and autistic-like traits (mean ratio, 1.22, 95% CI, 1.01 to 1.47) in female. A stressful family environment mediated ~ 70% of the association with internalizing problems in females, ~ 30% with autistic-like traits in females, and ~ 20% with externalizing problems in males. Despite observable brain morphometric changes related to adolescent motherhood, these did not act as mediating factors in our analysis, after adjusting for family environment. No elevated rate of adverse perinatal outcomes was observed in the offspring of adolescent mothers in this study. CONCLUSIONS: Our results reveal distinct sex-specific neurodevelopmental outcomes impacts of being born to adolescent mothers, with a substantial mediating effect of family environment on behavioral outcomes. These findings highlight the importance of developing sex-tailored interventions and support the hypothesis that family environment significantly impacts the neurodevelopmental consequences of adolescent motherhood.
背景：先前的研究表明，青少年母亲与后代不良的神经发育结局相关，但性别特异性效应和潜在机制仍不清楚。
方法：本研究纳入了来自青少年大脑认知发展研究的 6952 名 9-11 岁儿童。暴露组为母亲在分娩时年龄<20 岁的儿童，而未暴露组为母亲在分娩时年龄为 20-35 岁的儿童。我们采用广义线性混合模型来研究青少年母亲与后代认知、行为和自闭症样特征的关联。我们应用逆概率加权边际结构模型来检验潜在的中介因素，包括不良围产期结局、家庭冲突和脑结构改变。
结果：我们的研究结果表明，青少年母亲的子女认知评分显著降低（β，-2.11，95%置信区间，-2.90 至-1.31），男性子女的外化问题增加（均值比，1.28，95%置信区间，1.08 至 1.52），女性子女的内化问题（均值比，1.14，95%置信区间，0.99 至 1.33）和自闭症样特征（均值比，1.22，95%置信区间，1.01 至 1.47）升高。有压力的家庭环境中介了约 70%女性内化问题、约 30%女性自闭症样特征、约 20%男性外化问题与青少年母亲之间的关联。尽管观察到与青少年母亲相关的脑形态学变化，但在调整家庭环境后，这些变化在我们的分析中并未作为中介因素。在这项研究中，青少年母亲的子女没有观察到更高的不良围产期结局发生率。
结论：我们的研究结果揭示了青少年母亲所生孩子的神经发育结局存在明显的性别特异性影响，家庭环境对行为结局具有显著的中介作用。这些发现强调了制定针对性别差异的干预措施的重要性，并支持了家庭环境对青少年母亲神经发育后果具有重要影响的假设。
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