妊娠期高血压疾病与婴儿神经行为发育关系的出生队列研究

The association between hypertension disorders in pregnancy and the neurodevelopment of infants:a birth cohort study

目的 探讨妊娠期高血压疾病(hypertension disorders in pregnancy, HDP)与婴儿神经行为发育的关系。方法 基于佛山市妇幼保健信息系统出生队列数据,选取2016―2021年在佛山市妇幼保健院产检、分娩的孕产妇及其子代17 812对,采用《0岁~6岁儿童发育行为评估量表》评估婴儿不同月龄的神经行为发育情况。以孕期有HDP暴露史的研究对象为暴露组,采用1∶1倾向性评分匹配对照组,共纳入1 414对母子对。采用广义估计方程分析HDP与婴儿神经行为发育的关系。结果 HDP组婴儿在3、6、8、12月龄的总发育商和各能区发育商均低于对照组(均P<0.05)。控制混杂因素后,HDP暴露仍是婴儿神经行为发育的危险因素,总发育商的β值(95%CI)为-5.72(-6.80~-4.63);HDP与婴儿大运动(β=-5.35,95%CI:-6.86~-3.84,P<0.01)、精细动作(β=-5.64,95%CI:-6.92~-4.35,P<0.01)、适应能力(β=-5.88,95%CI:-7.26~-4.49,P<0.01)、语言(β=-5.80,95%CI:-7.10~-4.50,P<0.01)和社会行为能区发育商(β=-5.91,95%CI:-7.11~-4.72,P<0.01)降低有关。结论 HDP是婴儿神经行为发育的危险因素,与婴儿大运动、精细动作、适应能力、语言和社会行为能区发育呈负相关。

Objective To investigate the association between hypertension disorders in pregnancy(HDP)and the neurodevelopment of infants.Methods The study utilized birth cohort data from the Foshan maternal and child health information system to select a sample of 17812 pairs of maternals who received antenatal care at a women and children hospital and their offsprings born at the same facility.The neurodevelopment of the infants was assessed using the Neuropsychological Examination Scale for Chinese Children(NESCC)at various intervals throughout the study.Maternals who were exposed to HDP during gestation were categorized as the exposure group,with the control group selected using a 1:1 propensity score matching method.A total of 1414 pairs of mothers and children were included in the study.The study employed generalized estimation equations to examine the association between HDP and the neurodevelopmental outcomes of infants.Results The study found that infants exposed to HDP exhibited lower development quotients in total and individual neurodevelopmental domains at 3,6,8 and 12 months compared to infants without HDP exposure(all P<0.05).Even after confounding factors were controlled,HDP exposure remained a significant risk factor for the neurodevelopment of infants,with the partial regression coefficient(β)and(95%CI)of-5.72(-6.80--4.63).Specifically,HDP exposure was negatively associated with gross motor,fine motor,adaptability,language,and social behavior development,with a partial regression coefficients(β)and 95%CI of-5.35(-6.86--3.84),-5.64(-6.92--4.35),-5.88(-7.26--4.49),-5.80(-7.10--4.50)and-5.91(-7.11--4.72),respectively.Conclusions HDP has been identified as a risk factor for the neurodevelopment of infants,exhibiting negative associations with the development of gross motor,fine motor,adaptability,language and social behavior.