肥胖孕妇的子女语言能力较弱

休斯敦——内分泌学会(ES)年会上公布的研究结果显示，孕中期肥胖与后代神经认知功能测验评分较低相关。研究者起初是在一项针对其他研究目的而开展的病例对照研究中意外发现这一现象，然后鉴于目前肥胖流行的情况，采用完全不同的数据集对这一结果进行了验证。

这两项研究均由缅因州士嘉堡血液研究基金会的Wendy Y. Craig博士及其同事进行。第一项研究纳入101例儿童，在这些儿童2岁时，研究者采用第3版贝利婴儿发育量表(BSID-Ⅲ)对其进行神经认知功能检查。他们的母亲在2004 ~2006年期间怀孕，30%孕中期肥胖。

妊娠期间体重正常、超重和肥胖者的后代之间，平均BSID-Ⅲ认知和运动评分无显著差异。然而，正常体重、超重和肥胖孕妇的后代的平均BSID-Ⅲ语言评分分别为110.6分、107.2分 和98.0分，差异具有高度统计学意义(P=0.009)。此外，在多变量回归分析中校正潜在混杂因素后发现，BSID-Ⅲ综合评分低于85分的儿童比例随孕妇体重增加而升高，在正常体重、超重和肥胖孕妇的后代中，该比例分别为3.1%、7.7%和33.3%。

第二项研究纳入118例儿童，在这些儿童8岁时，研究者采用韦氏儿童智力量表(WISC-III)对其进行检查。他们的母亲在1987~1990年期间怀孕(比第一项研究人群的怀孕时间早15年)，而且仅有10%孕中期肥胖。肥胖孕妇的后代的未校正WISC-Ⅲ操作智商平均分比体重正常孕妇的后代低10.7分。同样，肥胖孕妇的后代的总量表智商和言语分量表平均分分别比体重正常孕妇的后代低9.2分和6.4分。

尽管不能排除所观察到的关系可能是由研究中未测定的其他协变量引起，但孕妇体重对后代早期神经认知发育的独立影响值得进一步研究。

这两项研究中的受试者均来自缅因州妊娠计划。这两项研究获美国国立儿童健康与人类发育研究所、Thrasher基金会和Knoll制药公司支持。Craig博士声明无经济利益冲突。

爱思唯尔  版权所有

By: BRUCE JANCIN, Clinical Endocrinology News Digital Network

HOUSTON – Second-trimester maternal obesity was associated with lower scores in offspring on neurocognitive tests in early childhood.

This observation initially came as an unexpected finding, a byproduct of a case-control study set up for another purpose. But the disturbing finding, particularly in light of the ongoing obesity epidemic, led researchers to take a second look at the issue using an entirely separate data set. Those findings were confirmatory, Wendy Y. Craig, Ph.D., of the Foundation for Blood Research in Scarborough, Maine, reported at the annual meeting of the Endocrine Society.

The initial study involved a cohort of 101 children who underwent neurocognitive testing at age 2 years using the Bayley Scales of Infant Development, Third Edition (BSID-III). Their mothers, who were pregnant during 2004-2006, had a 30% prevalence of second trimester obesity.

The mean BSID-III cognitive and motor scores didn’t differ significantly between offspring of mothers who were normal-weight, overweight, or obese in pregnancy. However, mean BSID-III language scores averaged 110.6 in the children of normal-weight mothers, 107.2 in those whose mothers were overweight, and 98.0 in children born to women with second trimester obesity; that difference was highly statistically significant (P = .009).

Moreover, after adjustment for potential confounders in a multivariate regression analysis, it was apparent that the proportion of children with a BSID-III composite score below 85 rose with increasing maternal weight in pregnancy. The rate was 3.1% in the offspring of normal weight mothers, 7.7% in kids whose mothers were overweight, and 33.3% in those whose mothers were obese.

The second study included 118 children tested at age 8 years using the Wechsler Intelligence Scale for Children (WISC-III). Their mothers had been pregnant during 1987-1990, or 15 years earlier than in the first study population, and their prevalence of second-trimester obesity in that earlier, leaner era was a mere 10%.

The mean unadjusted WISC-III performance IQ score for children whose mothers were obese in pregnancy was 10.7 points lower than children of normal-weight mothers. Similarly, the full scale IQ and verbal subscale scores were lower by an average of 9.2 and 6.4 points, respectively.

"Although we cannot rule out the possibility that other covariates not measured in this study were responsible for the observed relationships, an independent effect of maternal obesity on the child’s early neurocognitive development deserves further investigation," Dr. Craig concluded.

All participants in both studies were recruited from the Maine statewide pregnancy project. The studies were supported by the National Institute of Child Health and Human Development, the Thrasher Fund, and Knoll Pharmaceuticals. Dr. Craig reported having no financial conflicts.