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Neurodevelopmental outcomes of infants born at high altitude: evidence from Tibet
Yang Zhou1, Xinqin Liu1, Qian Zhang1
1Department of Occupational and Environmental Health, Shanxi Key Laboratory of Environment Health Hazard Assessment and Protection, Ministry of Education Key Laboratory of Hazard Assessment and Control in Special Operational Environment, The Fourth Military Medical University, Xi'an, China.
Background:
In contrast to the extensive research on the effects of high-altitude exposure on adult neurological function, fetal and pediatric neurodevelopment in high-altitude environments has received relatively little attention. This study aimed to determine whether exposure to high-altitude exposure during gestation and infancy could influence neurodevelopmental outcomes compared with low-altitude infants.
Methods:
A total of 50 high-altitude-born and 100 low-altitude-born infants were studied. Parents were followed longitudinally and instructed to complete the Ages and Stages Questionnaire, 3rd edition (ASQ-3), when their infants reached 6, 12, and 18 months of age. The primary outcome measures included neurodevelopmental scores and the proportion of infants classified as failing in the five ASQ-3 domains.
Results:
High-altitude infants had lower gross motor scores and higher failure rates. Subgroup analysis revealed no significant differences attributable to confounding factors. Regression analysis identified high-altitude exposure as the only significant predictor of gross motor delay.
Conclusions:
Prenatal and postnatal exposure to high-altitude exposure was found to be associated with an increased risk of gross motor neurodevelopmental delay in infants.
Impact:
This is the first prospective cohort study to compare the neurodevelopmental outcomes of high-altitude born/raised infants with those of low-altitude controls. Infants born and raised at high-altitude exhibited lower neurodevelopmental scores and a higher likelihood of failing in the gross motor domain of ASQ-3. High-altitude exposure had no negative influence on infants' physical growth and other neurodevelopmental domains assessed by the ASQ-3.
