太多太少:澄清母亲摄入量与神经发育结果之间的关系
Thomas R Sullivan1, Karen P Best2, Jacqueline Gould2
1SAHMRI Women and Kids Theme, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia; Faculty of Health and Medical Sciences, School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
The Journal of nutrition
|September 16, 2023
概括
怀孕期间最佳的摄入对于儿童神经发育至关重要. 低和高水平都与儿童认知和语言成绩较差有关,这表明需要有针对性的补充剂.
科学领域:
- 营养科学 营养科学
- 发展心理学 发展心理学
- 公共卫生政策 公共卫生政策
背景情况:
- 澳大利亚的强化政策包括面包盐 (2009) 和孕妇/哺乳期妇女补充剂 (2010).
- 以前对充足的人群的评估表明,在母亲摄入量最高/最低的四分位数中,儿童神经发育较差.
- 对儿童神经发育的最佳母体摄入范围以前没有量化.
研究的目的:
- 确定怀孕期间母亲摄入量与儿童最佳神经发育相关的特定范围.
- 调查产前暴露与儿童早期认知和语言发展之间的剂量反应关系.
主要方法:
- 一项前性队列研究,涉及699名孕妇及其子女.
- 怀孕16周和28周通过食物频率问卷评估母亲的摄入量.
- 儿童神经发育在18个月时使用贝利婴幼儿发育量表 (Bayley Scales of Infant and Toddler Development,第三版 (Bayley-III)) 进行评估.
- 统计分析采用线性回归与小数多项式来建模摄入量与神经发育得分之间的关系,并对混因素进行调整.
主要成果:
- 平均母亲摄入量为308 (120) 微克/天,82%使用补充剂.
- 观察到,母亲的摄入量与孩子的贝利-III认知 (P=0.001) 和语言 (P=0.004) 评分之间存在显著的曲线关系.
- 较差的神经发育结果与约合摄入量低于大约185μg/d和高于350-370μg/d有关.
- 较高的摄入量,主要来自补充剂,与对认知和语言评分的负面影响有关.
结论:
- 母亲摄入量与儿童神经发育之间的关系是非线性的,在低摄入量和高摄入量时都有不良影响.
- 最佳的神经发育似乎发生在怀孕期间摄入量特定的中间范围内.
- 针对性补充剂,而不是通用方法,可能更适合孕妇饮食摄入不足.
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