State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
BMC Pregnancy Childbirth. 2024 Oct 2;24(1):636. doi: 10.1186/s12884-024-06839-8.
The recent Maternal Immune Activation (MIA) theory suggests maternal systemic inflammation may serve as a mediator in associations between prenatal maternal adversities and neurodevelopmental diseases in offspring. Given the co-exposure to multiple adversities may be experienced by pregnant person, it is unclear whether a quantitative index can be developed to characterize the inflammation related exposure level, and whether this index is associated with neurodevelopmental delays in offspring.
Based on Jiangsu Birth Cohort (JBC), a total of 3051 infants were included in the analysis. Inflammation related Prenatal Adversity Index (IPAI) was constructed using maternal data. Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, third edition, screening test in one year. Multivariate linear regression and Poisson regression model were performed to analyze the associations between IPAI and neurodevelopment in offspring.
Compared with "low IPAI" group, offspring with "high IPAI" have lower scores of cognition, receptive communication, expressive communication, and fine motor. The adjusted β were - 0.23 (95%CI: -0.42, -0.04), -0.47 (95%CI: -0.66, -0.28), -0.30 (95%CI: -0.49, -0.11), and - 0.20 (95%CI: -0.33, -0.06). Additionally, the elevated risk for noncompetent development of cognition and receptive communication among "high IPAI" group was observed. The relative risk [RR] and 95% confidence interval [CI] were 1.35 (1.01, 1.69) and 1.37 (1.09, 1.72).
Our results revealed a significant association between higher IPAI and lower scores across cognition, receptive communication, expressive communication, and fine motor domains, and an increased risk of noncompetent development in the cognition and receptive communication domains.
最近的母体免疫激活（MIA）理论表明，母体全身炎症可能是母体产前逆境与后代神经发育疾病之间关联的中介。鉴于孕妇可能同时暴露于多种逆境，目前尚不清楚是否可以开发出一个定量指标来描述与炎症相关的暴露水平，以及该指数是否与后代的神经发育迟缓有关。
基于江苏出生队列（JBC），共纳入 3051 名婴儿进行分析。采用母体数据构建与炎症相关的产前逆境指数（IPAI）。在一岁时使用贝利婴幼儿发育量表第三版筛查测试评估神经发育结果。采用多元线性回归和泊松回归模型分析 IPAI 与后代神经发育的关系。
与“低 IPAI”组相比，“高 IPAI”组的后代认知、接受性沟通、表达性沟通和精细运动的得分较低。调整后的β值分别为-0.23（95%CI：-0.42，-0.04）、-0.47（95%CI：-0.66，-0.28）、-0.30（95%CI：-0.49，-0.11）和-0.20（95%CI：-0.33，-0.06）。此外，还观察到“高 IPAI”组认知和接受性沟通能力发育不全的风险增加。相对风险[RR]和 95%置信区间[CI]分别为 1.35（1.01，1.69）和 1.37（1.09，1.72）。
我们的研究结果表明，较高的 IPAI 与认知、接受性沟通、表达性沟通和精细运动等领域的得分较低以及认知和接受性沟通领域发育不全的风险增加之间存在显著关联。
