母体妊娠合并症、孕期体重及喂养方式对子代神经行为发育的影响OA

Objective To investigate the effects of maternal pregnancy complications,gestational weight gain,and feeding methods on offspring neurobehavioral development.Methods A retrospective cohort study was conducted,enrolling 527 mother-infant pairs.The participants were divided into groups according to pregnancy complications,gestational weight gain,and feeding methods for follow-up assessment.The Gesell Developmental Scale was used to evaluate the neurobehavioral development of the infants at 6,12,and 18 months of age.Multivariate linear regression analysis was applied to examine the independent effects of each factor.Results The fine motor development quotient(92.6±8.7)at 12 months of age in the gestational diabetes mellitus(GDM)group was significantly lower than that in the control group(100.9±9.4,t=-6.12,P<0.01),and both fine motor and adaptive behavior development were impaired at 18 months of age(t=-5.34 and-4.02,respectively,P<0.05).In the hypertensive disorders complicating pregnancy(HDCP)group,the language development score(90.3±9.5)at 18 months of age was lower than that in the control group,but the difference was not statistically significant(96.8±8.7,t=1.34,P>0.05).The combined GDM and HDCP group had the lowest developmental indices,with both adaptive behavior and language development indices at 18 months of age being significantly lower than those in the single-complication groups and the control group(t=4.28 and 5.17,respectively,P<0.01).The adaptive behavior development index in the excessive gestational weight gain group was 5.7 points lower than that in the appropriate weight gain group(t=3.95,P<0.05),and it showed an inverted U-shaped correlation with cognitive development(r=-0.328,P<0.01).The exclusive breastfeeding group was significantly superior to the formula feeding group in the domains of adaptive behavior,language,and fine motor skills(t=5.26,6.37 and 4.89,respectively,P<0.01),while the mixed feeding group had indices between the two.Multivariate linear regression analysis showed that GDM,HDCP,and excessive gestational weight gain significantly reduced the offspring neurodevelopmental index at 18 months of age(β=-4.26,-5.18 and-3.95,respectively,P<0.05),while exclusive breastfeeding significantly increased the offspring neurodevelopmental index at 18 months of age(β=6.37,P<0.01).There was a synergistic negative interaction between pregnancy complications and excessive gestational weight gain,and exclusive breastfeeding had a more significant beneficial effect on neurodevelopment in offspring of high-risk populations with pregnancy complications.Conclusion GDM,HDCP,and excessive gestational weight gain can reduce the neurobehavioral development level of the offspring,while exclusive breastfeeding can improve it.Clinical attention should be paid to the whole perinatal management to improve children's neurodevelopmental outcomes.