Cendra-Duarte Esther, Canals Josefa, Becerra-Tomás Nerea, Mateu-Fabregat Javier, Bulló Mònica, Arija Victoria
Universitat Rovira i Virgili, Unitat de Salut Pública i Epidemiologia Nutricional, Nutrition and Mental Health (NUTRISAM) Research Group, Reus, Spain.
Collaborative Group On Lifestyles, Nutrition, and Tobacco (CENIT), Institut d'Investigació en Atenció Primària IDIAP Jordi Gol, Institut Català de La Salut (ICS), Reus, Spain.
Eur J Pediatr. 2025 Feb 6;184(2):178. doi: 10.1007/s00431-025-06005-y.
Given the importance of carbohydrates during pregnancy and the limited evidence on the impact of its excessive intake on offspring neurodevelopment, this study aimed to assess the associations between maternal glycemic index (GI) and glycemic load (GL) during early and late pregnancy and behavior problems in 4-year-old children, considering potential sex-related differences in susceptibility to maternal diet. This observational study included 188 mother-child pairs from the ECLIPSES study. GI and GL were estimated from a validated food frequency questionnaire. Offspring behavior was assessed using the Child Behavior Checklist 1.5-5. Multivariable linear and logistic regression analyses were employed to assess the association between GI, GL, and child behavior. Children of mothers in the highest tertile of GL during the first trimester of pregnancy showed elevated scores of both internalizing (β = 5.77; 95% CI, 2.28-9.26) and externalizing (β = 3.95; 95% CI, 0.70-7.19) problems, including anxiety and depression problems, withdrawn, attention problems, aggressive behavior, and attention-deficit/hyperactivity problems, as well as total (β = 5.24; 95% CI, 1.71-8.77) and autism spectrum problems (β = 3.30; 95% CI, 1.11-5.50). Similarly, higher odd ratios were observed for internalizing (OR = 2.37; 95% CI, 1.09-5.18), externalizing (OR = 3.46; 95% CI, 1.49-8.00), and total problems (OR = 3.83; 95% CI, 1.68-8.71). These associations were more pronounced in girls. No associations were observed during the third trimester. Regarding GI, no associations were found for the evaluated outcomes in any of the trimesters.
These findings indicated that elevated maternal GL during the early pregnancy, but not later stages, was associated with adverse behavioral outcomes in offspring.
EUCTR-2012-005480-28, NCT03196882.
• Carbohydrate intake is important during pregnancy as glucose is the main energy source for an optimal fetal brain development. • Elevated prenatal glycemic index and glycemic load have been associated with adverse offspring outcomes but their impact on behavioral development remains insufficiently explored.
• A high maternal glycemic load during pregnancy may increase the risk of behavioral impairments in preschool-aged offspring. • Female offspring may be more vulnerable to behavioral disturbances to elevated maternal glycemic load during gestation.
鉴于孕期碳水化合物的重要性以及关于其过量摄入对后代神经发育影响的证据有限，本研究旨在评估孕早期和晚期孕妇血糖指数（GI）和血糖负荷（GL）与4岁儿童行为问题之间的关联，并考虑潜在的性别差异对母体饮食易感性的影响。这项观察性研究纳入了来自ECLIPSES研究的188对母婴。GI和GL通过经过验证的食物频率问卷进行估算。使用儿童行为检查表1.5 - 5评估后代行为。采用多变量线性和逻辑回归分析来评估GI、GL与儿童行为之间的关联。孕期头三个月GL处于最高三分位数的母亲所生的孩子，其内化问题（β = 5.77；95%置信区间，2.28 - 9.26）和外化问题（β = 3.95；95%置信区间，0.70 - 7.19）得分均升高，包括焦虑和抑郁问题、退缩、注意力问题、攻击行为以及注意力缺陷/多动问题，还有总问题（β = 5.24；95%置信区间，1.71 - 8.77）和自闭症谱系问题（β = 3.30；95%置信区间，1.11 - 5.50）。同样，内化问题（比值比[OR] = 2.37；95%置信区间，1.09 - 5.18）、外化问题（OR = 3.46；95%置信区间，1.49 - 8.00）和总问题（OR = 3.83；95%置信区间，1.68 - 8.71）的比值比更高。这些关联在女孩中更为明显。孕晚期未观察到关联。关于GI，在任何一个孕期阶段，所评估的结果均未发现关联。
这些发现表明，孕早期而非孕晚期母体GL升高与后代不良行为结果相关。
EUCTR - 2012 - 005480 - 28，NCT03196882。
• 孕期碳水化合物摄入很重要，因为葡萄糖是胎儿大脑最佳发育的主要能量来源。• 产前血糖指数和血糖负荷升高与后代不良结局相关，但其对行为发育的影响仍未得到充分探索。
• 孕期母体高血糖负荷可能增加学龄前后代出现行为障碍的风险。• 雌性后代可能更容易受到孕期母体高血糖负荷导致的行为干扰。
