Krzeczkowski John E, Mortaji Neda, Atkinson Stephanie, Schmidt Louis A, Van Lieshout Ryan J
Department of Health Sciences, Brock University, St. Catharines, ON, Canada.
Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada.
Am J Clin Nutr. 2025 Jan;121(1):50-59. doi: 10.1016/j.ajcnut.2024.10.022. Epub 2024 Oct 30.
Human studies examining the influence of prenatal diet and/or exercise interventions on offspring neurodevelopment are mixed. Interventions that include the provision of whole foods, nutritional counseling, address exercise behaviors, and that utilize multimethod assessments of offspring emotion regulation (ER) may better reveal the impact of these interventions on neurodevelopment.
To explore whether the Be Healthy in Pregnancy (BHIP) prenatal diet-and-exercise intervention improves ER in 22-mo-old offspring.
Pregnant persons (>18 y, singleton pregnancy) were recruited between 12 and 17 wk gestation and randomly assigned to the intervention [high protein energy-controlled diet via the provision of cottage cheese, Greek yogurt, low-fat milk, individualized biweekly nutritional counseling, a controlled walking program, and usual pregnancy care (UPC)] or control (UPC alone) groups. ER in offspring [m = 22.2 (SD = 4.04); 50.9% female; intervention: n = 29, control: n = 28] was assessed using reports from pregnant persons and their partners on the Child Behavior Checklist, and the Behavior Rating Inventory of Executive Function-Preschool Version, laboratory observational tasks examining inhibitory control, attention, and empathy, and high-frequency heart rate variability (HF-HRV).
Children exposed to the BHIP intervention exhibited medium to large effect size reductions in pregnant person and partner reported externalizing [effect size ƞp = 0.08, 95% confidence interval of the difference (0.05, 7.14); ƞp = 0.17 (1.68, 9.65)], internalizing [ƞp = 0.08 (0.09, 5.32); ƞp = 0.13 (0.84, 8.88)], and total behavior problems [ƞp = 0.09 (0.72, 11.87); ƞp = 0.17 (3.17, 17.88)] relative to control participants' children. Pregnant persons, but not partners, reported fewer problems with inhibitory control [ƞp = 0.13 (1.40, 8.55)], cognitive flexibility [ƞp = 0.08 (0.18, 4.85)], emergent metacognition [ƞp = 0.14 (2.00, 11.59)], and global executive function [ƞp = 0.14 (3.37, 20.12)]. Intervention children displayed fewer impulsive behaviors [ƞp = 0.11 (0.16, 1.77)] and a longer attention span [ƞp = 0.08 (0.30, 13.34)]. Finally, intervention children exhibited greater baseline HF-HRV [ƞp = 0.10 (0.16, 2.01)], and adaptive HF-HRV reactivity during the impulsivity [ƞp = 0.12 (0.20, 2.19)], and attention tasks [ƞp = 0.21 (0.74, 2.77)].
This intervention was associated with medium/large effect size improvements in offspring ER. Larger trials are needed to confirm the potential of these interventions on offspring neurodevelopment.
This trial was registered at www.
gov as NCT01689961 (21 September, 2012).
关于产前饮食和/或运动干预对后代神经发育影响的人体研究结果不一。包括提供全食物、营养咨询、关注运动行为以及采用多种方法评估后代情绪调节（ER）的干预措施，可能会更好地揭示这些干预对神经发育的影响。
探讨孕期健康（BHIP）产前饮食和运动干预是否能改善22个月大后代的ER。
招募妊娠12至17周的孕妇（>18岁，单胎妊娠），并随机分配至干预组[通过提供农家干酪、希腊酸奶、低脂牛奶进行高蛋白能量控制饮食，每两周进行一次个性化营养咨询，一个有控制的步行计划，以及常规孕期护理（UPC）]或对照组（仅UPC）。使用孕妇及其伴侣关于儿童行为清单的报告、执行功能学前版行为评定量表、检查抑制控制、注意力和同理心的实验室观察任务以及高频心率变异性（HF-HRV）来评估后代的ER[平均年龄m = 22.2（标准差SD = 4.04）；50.9%为女性；干预组：n = 29，对照组：n = 28]。
与对照组参与者的孩子相比，接受BHIP干预的儿童在孕妇和伴侣报告的外化行为[效应量ƞp = 0.08，差异的95%置信区间（0.05，7.14）；ƞp = 0.17（1.68，9.65）]、内化行为[ƞp = 0.08（0.09，5.32）；ƞp = 0.13（0.84，8.88）]和总行为问题[ƞp = 0.09（0.72，11.87）；ƞp = 0.17（3.17，17.88）]方面表现出中等到较大的效应量降低。孕妇（而非伴侣）报告干预组儿童在抑制控制[ƞp = 0.13（1.40，8.55）]、认知灵活性[ƞp = 0.08（0.18，4.85）]、新兴元认知[ƞp = 0.14（2.00，11.59）]和整体执行功能[ƞp = 0.14（3.37，20.12）]方面的问题较少。干预组儿童表现出较少的冲动行为[ƞp = 0.11（0.16，1.77）]和更长的注意力持续时间[ƞp = 0.08（0.30，13.34）]。最后，干预组儿童表现出更高的基线HF-HRV[ƞp = 0.10（0.16，2.01）]，以及在冲动性任务[ƞp = 0.12（0.20，2.19）]和注意力任务[ƞp = 0.21（0.74，2.77）]期间适应性HF-HRV反应性更高。
该干预与后代ER中等到较大效应量的改善相关。需要更大规模的试验来证实这些干预对后代神经发育的潜在作用。
