围产期唾液酸营养与足月儿早期智能发育相关性的研究

Relationship between the level of sialic acid during perinatal period and early intelligence development of full term infants

目的 分析围产期唾液酸（SA）营养状况与健康足月儿早期智能发育的关系,探讨SA水平对早期智能发育的影响.方法 采取前瞻性队列研究,随机调查127对南通大学附属医院健康产妇及其婴儿,对产妇问卷调查,采用酶联免疫吸附法测定母婴体液SA水平,婴儿出生后3～4个月评估精神发育指数（MDI）和运动发育指数（PDI）.结果 共获得120对完整的资料：母血、脐血及初乳中的SA水平分别为（2.25±0.02）、（1.21±0.01）、（5.01±0.06） mmol/L;3～4月龄的婴儿MDI和PDI分别为（99.40±1.87）、（98.53±1.96）.多元逐步回归分析表明：MDI与脐血及初乳中的SA水平相关（β=0.636、0.175,P＜0.05）,PDI与脐血及初乳中的SA水平相关（β=0.502、0.262,P＜0.05）.脐血高SA组的MDI、PDI均显著高于低SA组（111.85±2.79）vs.（108.88±2.0）,（101.08±4.44）vs.（98.88±2.0）,P均＜0.01;初乳高SA组的MDI、PDI均显著高于低SA组（111.71 ±3.07）vs.（108.81±1.56）,P＜0.01;（101.29±4.23）vs.（98.56±1.79）,P＜0.05.初乳与脐血SA水平呈正相关（r =0.507,P=0.004）;初乳及脐血SA水平在母血高SA组均显著高于低SA组（5.12±0.35）vs.（4.87±0.22）,（1.21±0.02）vs.（1.17±0.01）,P均＜0.05.结论 脐血及初乳唾液酸高水平可能有益于足月儿早期智能发育,围产期充足的唾液酸摄入和良好的胎盘功能可能是早期智能发育的重要因素.

Objective To investigate the correlation between the status of sialic acid （SA） during perinatal period and early intelligence development of healthy full term infant,and to explore the effect of SA on the early intelligence development.Method A total of 127 pairs of healthy mothers-neonates in the Affiliated Hospital of Nantong University were recruited randomly in this prospective cohort study.The levels of SA from body fluids of mothers-neonates were measured by enzyme-linked immunosorbent assay,such as the full-term maternal and cord blood and the colostrum.The questionnaire surveys were carried out in mothers and mental development evaluation according to Children＇s Development Center of China （CDCC） were carried out in infants 3 to 4 months of age to obtain the mental development index （MDI） and psychomotor development index （PDI）.Result A total of 120 pairs of maternal-neonatal subjects with complete data were included into statistical analysis.The levels of SA of maternal and cord blood and colostrum were （2.25 ±0.02）,（1.21 ±0.01）,and （5.01 ±0.06） mmol/L respectively.MDI and PDI of infants 3 to 4 months of age were （99.40 ± 1.87） and （98.53 ± 1.96）.The analysis using multiple linear regression indicated that MDI was associated with SA levels of cord blood and colostrum （β =0.636,0.175,P 〈0.05）,and PDI was also associated with them （β =0.502,0.262,P 〈0.05）.The levels of SA of cord blood and colostrums were individually divided into high-level group and low-level one according to the median level.MDI and PDI in high-level group of cord blood were both significantly higher than that in lowlevel group （111.85 ± 2.79） vs.（108.88 ± 2.0）,（101.08 ± 4.44） vs.（98.88 ± 2.0） P 〈 0.01.So were MDI and PDI in high-level group of colostrum compared with those in low-level group （111.71 ±3.07） vs.（108.81 ± 1.56）,P 〈 0.01 ; （101.29 ± 4.23） vs.（98.56 ± 1.79）,P 〈 0.05.The analysis on correlation between the levels of maternal-neonatal body fluids showed that the level of SA of colostrum was positively correlated with that of cord blood （r =0.507,P =0.004）.However,no correlation was found either between the level of SA of maternal and cord blood or between the level of SA of maternal blood and colostrums.Further division into high-level and low-level groups was done according to the median level of maternal blood.The levels of SA of colostrum and cord blood in high-level group were markedly higher than those in low-levelone （5.12±0.35） vs.（4.87 ±0.22） and （1.21 ±0.02） vs.（1.17±0.01）,P〈0.05.Conclusion High levels of SA of cord blood and colostrums might be beneficial to the early intelligence development of full term infant.Abundant intake of SA during perinatal period and good function of placenta may play important role in early intelligence development.