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围孕期叶酸补充对子代6岁智商影响及孕期坚果摄入和母乳喂养的效应修饰作用 被引量:1

Association of periconceptional folic acid supplementation with the intelligence quotient of offspring at 6-year-old and modification effects of nuts consumption during pregnancy and breastfeeding:a birth cohort study in Shanghai
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摘要 目的评估母亲围孕期叶酸补充与子代远期智力发育的关联,并检验孕期食用坚果和母乳喂养对该关联可能产生的效应修饰作用。方法2012年4—12月上海闵行出生队列建立时,通过结构式问卷收集母亲围孕期叶酸补充情况、坚果食用频率等信息;子代出生后,通过随访收集纯母乳喂养时长等信息,并于子代6岁时,由经过专业培训的调查员利用第四版《韦氏儿童智力量表》中文版简版对其进行智力水平测试。最终纳入信息完整的530对母子,采用多因素线性回归模型分析母亲围孕期叶酸补充与子代6岁智商分数的关联,并探讨母亲孕期坚果食用频率及产后纯母乳喂养时长的潜在效应修饰作用。结果多因素分析结果显示,对于母亲围孕期叶酸补充的子代,其知觉推理分数提高4.57分(95%CI=0.13~9.02)。母亲孕前开始补充叶酸与孕后开始补充叶酸与子代知觉推理分数关联的效应值相近,分别为4.41(95%CI=-0.25~9.07)和4.71(95%CI=0.11~9.31)。另外,上述关联在母亲孕期坚果食用频率≤2 d/周、纯母乳喂养时长<6个月的研究对象中更强;前者,母亲围孕期补充叶酸的子代知觉推理分数提高5.80分(95%CI=0.52~11.08),后者母亲围孕期补充叶酸的子代知觉推理分数提高6.36分(95%CI=0.89~11.83)。结论母亲围孕期叶酸补充与子代6岁时知觉推理分数的提高有关,提示围孕期叶酸补充对子代远期智力发育的保护作用。该保护作用在母亲孕期坚果食用频率≤2 d/周或子代纯母乳喂养时长<6个月的研究人群中更强。 Objective To evaluate long-term impact of periconceptional folic acid supplementation on the intelligence quotient(IQ)of offspring,as well as potential modification effects of nuts consumption during pregnancy and breastfeeding duration on the association of maternal folic acid supplementation with offspring′s IQ.Methods The information on maternal folic acid supplementation and frequency of nuts consumption was collected through a structured questionnaire interview conducted at 12-16 gestational weeks among pregnant women being enrolled in the Shanghai-Minhang Birth Cohort Study(S-MBCS)during April-December,2012.Information on duration of exclusive breastfeeding of the mothers was collected during postnatal follow-up visits.The mothers′children were followed up and the children′s intellectual development at the age of 6 years was evaluated with Wechsler Intelligence Scale for Children,Fourth Edition(WISC-IV)-simplified Chinese Version at follow-ups by well-trained interviewers.Eventually,530 mother-child pairs with complete information were included in this study.Multiple linear regression model was used to analyze the correlation between periconceptional folic acid supplementation and the children′s IQ at age of 6 years and to explore potential modification effects of frequency of maternal nuts consumption during pregnancy or duration of exclusive breastfeeding on the correlation.Results Multiple analysis showed that the children with maternal folic acid supplements regularly during periconceptional period had better IQ performance,with significantly increased scores of perceptual reasoning index(PRI)of 4.57(95%confidence interval[95%CI]:0.13-9.02)compared to the children without the maternal supplementation;such effect of maternal folic acid supplementation beginning before the pregnancy was similar to that of supplementation beginning after the pregnancy,with the increased PRI scores of 4.41(95%CI:-0.25-9.07)and 4.71(95%CI:0.11-9.31),respectively.In addition,the effect of maternal folic acid supplementation on the children′s PRI was stronger when combined by maternal nuts consumption of≤2 days/week during pregnancy(increased PRI=5.80,95%CI:0.52-11.08)or by exclusive breastfeeding of their children less than 6 months(increased PRI=6.36,95%CI:0.89-11.83).Conclusion Maternal periconceptional folic acid supplementation is associated with the improvement of offspring’s PRI at 6 years,indicating a protective effect of the supplementation on long-term intelligence development of the children.The beneficial effect was more profound when the supplementation being combined by nuts consumption two days/per week and less during pregnancy or by exclusive breastfeeding of their children less than 6 months.
作者 苏慧佳 谢珍珍 孙松林 陈瑶 奚健雅 梁红 袁伟 纪红蕾 SU Huijia;XIE Zhenzhen;SUN Songlin;CHEN Yao;XI Jianya;LIANG Hong;YUAN Wei;JI Honglei(Shanghai-MOST Key Laboratory of Health and Disease Genomics,National Health Commission Key Lab of Reproduction Regulation,Shanghai Institute for Biomedical and Pharmaceutical Technologies,Shanghai 200237,China)
出处 《中国公共卫生》 CAS CSCD 北大核心 2024年第1期29-35,共7页 Chinese Journal of Public Health
基金 国家科技部重点研发计划项目(2021YFC2701003) 上海市卫生健康委员会课题(202104333)
关键词 叶酸 围孕期 子代智商 效应修饰 队列研究 folic acid periconception intelligence quotient of offspring modification effect cohort study
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