在叶酸临床试验中产生的儿童的随访 (事实4儿童):基于双盲随机对照试验的前性队列研究
Maryam Ghiasi1, Lonnie Zwaigenbaum2, Diane Moddemann3
1Acute Care Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.
BJOG : an international journal of obstetrics and gynaecology
|August 27, 2025
概括
在怀孕期间服用高剂量的叶酸补充剂并没有影响儿童的社会或行为发展. 这项研究表明,高剂量可能不必用于患有妊娠前的妇女.
科学领域:
- 神经科学
- 产前健康
- 发展心理学
背景情况:
- 自闭症谱系障碍 (ASD) 和执行功能缺陷是复杂的神经发育状况.
- 孕妇在怀孕期间的健康状况,包括叶酸摄入量,会影响胎儿的神经发育.
- 之前的研究表明,产前因素与儿童神经发育结果之间存在潜在的联系.
研究的目的:
- 研究怀孕期间高剂量叶酸补充剂 (4.0-5.1毫克) 对儿童社会障碍,执行功能和情绪/行为问题的影响.
- 评估高剂量叶酸补充剂的孕产妇患有妊娠前风险的婴儿的神经发育结果.
主要方法:
- 一个随访研究 (FACT 4儿童) 的母亲和孩子从叶酸临床试验 (FACT).
- 国际,多中心,双盲随机试验设计.
- 母亲使用验证的问卷报告了孩子 (4-9岁) 的社交,执行功能和情绪/行为问题.
主要成果:
- 在高剂量叶酸组 (13. 5%) 和安慰剂组 (14. 8%) 之间,社交障碍,执行功能或行为障碍的得分没有显著差异 (≥1.5 SD高于平均值).
- 相对风险 (RR) = 0. 91; 95% 的信心区间 (CI): 0. 63 到 1. 33; p 值 = 0. 63.
结论:
- 在怀孕8至16周之间开始服用高剂量的叶酸补充剂,并没有改变患有妊娠前风险的母亲产生的儿童的神经发育结果.
- 研究结果表明,高剂量的叶酸补充可能对高风险的孕妇来说是不必要的.
- 需要进一步进行大规模研究,以探索最佳的叶酸剂量和产前神经发育益处的时间.
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