生育间隔对子代神经心理发育的影响

Effects of inter-pregnancy interval on neuropsychological development of offspring

目的评估母亲生育间隔(inter-pregnancy interval,IPI)对子代神经心理发育的影响。方法基于北大通州出生队列项目(PKUBC-T),选取2018-2019年间在通州妇幼保健院就诊的421对母婴作为研究对象开展前瞻性队列研究。通过在孕早、中、晚期随访时通过问卷收集人口学、孕期行为方式及分娩等信息;在子代一岁内随访时通过年龄与发育进程问卷第三版(ASQ-3)收集子代一岁内沟通、粗大动作、精细动作、解决问题和个人-社会五个能区的神经心理发育情况。采用协方差分析、多元线性回归和多元逻辑回归分析IPI与子代神经心理发育的关系,同时在分层分析中进一步检验上述结果的稳定性。结果IPI与子代个人-社会得分呈正相关性,相比于短IPI组(IPI<50.33)的儿童,长IPI组(IPI≥80.94)的儿童个人-社会得分更高(β=3.350,95%CI:0.199,6.501);同时,IPI与子代个人-社会障碍发生风险呈负相关性,这种关系随IPI增长呈现递进趋势,中等和长IPI组(50.33≤IPI<80.94和IPI≥80.94)儿童个人-社会障碍的患病风险分别比短IPI组(IPI<50.33)的患病风险低6.9%(95%CI:0.1%,13.4%)和8.2%(95%CI:0.7%,15.1%)。以上两种效应在子代性别、孕期叶酸补充、生活压力以及生物因素暴露分层中出现了差异性。结论与IPI较短(IPI<50.33)的孕妇相比,IPI较长(50.33≤IPI<80.94和IPI≥80.94)的孕妇的子代个人-社会能区发生障碍的风险更低,且个人-社会得分更高。这种关联性受到子代性别、孕期叶酸补充、生活压力以及生物因素暴露的影响。

Objective To evaluate the effect of inter-pregnancy interval(IPI)on early neurodevelopmental disorders in children.Methods A prospective cohort study was conducted among 421 pairs of mothers and infants,a subset of the Peking University Birth Cohort in Tongzhou(PKUBC-T),who registered and delivered in Tongzhou Maternal and Child Health Care Hospital from 2018 to 2019.Demographic information,pregnancy behavior patterns and IPI were collected during the prenatal visit.Ages and Stages Questionnaive-3(ASQ-3)questionnaire was used to collect the developmental scores of children.Covariance analysis,multiple linear regression and multiple logistic regression models were used to analyze the association between IPI and early childhood development.Subgroup analysis was further conducted to validate the association.Results IPI was positively correlated with children individual-social scores.Compared with children whose mother experienced short IPI(IPI<50.33),those whose mother experienced long IPI(80.94≤IPI)had higher individual-social scores(β=3.350,95%CI:0.199,6.501).IPI was also negatively correlated with the risk of individual-social disorders among children,and this relationship showed a progressive trend with the increase of IPI.Children who in longer IPI group(50.33≤IPI<80.94 and IPI≤80.94)have lower risk of individual-social disorders[6.9%(95%CI:0.1%,13.4%)and 8.2%(95%CI:0.7%,15.1%)]than children who in shorter IPI group(IPI≤50.33).These effects varied across different genders of the newborn,folic acid supplementation during pregnancy,life stress,and exposure to biological factors.Conclusion The offspring of pregnant women with longer IPI(50.33≤IPI<80.94 and IPI≤80.94)had a lower risk of individual-social disorders and a higher individual-social score than those with shorter IPI(IPI≤50.33),and the association was influenced by factors such as the gender of newborn,folic acid supplementation during pregnancy,exposure to biological factors,and mental health.