JAMA Pediatr:产前微量元素补充是否影响青春期智力发育?

2018-11-03 吴星 环球医学

2018年9月,中国、英国和澳大利亚学者在《JAMA Pediatr》上发表的一项随机临床试验的14年随访,考察了产前微量元素补充与中国西部农村青春期智力发育的相关性。

2018年9月,中国、英国和澳大利亚学者在《JAMA Pediatr》上发表的一项随机临床试验的14年随访,考察了产前微量元素补充与中国西部农村青春期智力发育的相关性。

重要性:妊娠期补充微量元素与后代青春期智力发育的相关性未知。

目的:评估产前微量元素补充与青春期智力发育的长期相关性。

设计、地点和参与者:这项调查妊娠期补充微量元素的随机临床试验的14年随访研究在中国西部农村的2个县进行,研究对象为2118名青春期后代(年龄10~14岁),他们的母亲于2002年8月1日~2006年2月28日被随机分配到每天补充叶酸、叶酸+铁或复合微量元素胶囊的组中。2016年6月1日~2016年12月31日进行随访。2017年4月1日~2017年6月20日进行数据分析。

首要结局和测量指标:青少年智商总量表和言语理解、工作记忆、感知推理、处理速度指数通过儿童韦氏智力量表评估。

结果:2118名青少年后代中,1252人(59.1%)为男孩,866人(40.9%)为女孩,平均(SD)年龄11.7(0.87)岁,代表了符合入组标准的4488单胎活产中的47.2%。与叶酸补充相比,复合微量元素补充与智商总量表评分升高1.13分(95% CI,0.15~2.10)和言语理解指数升高2.03分(95% CI,0.61~3.45)相关;与叶酸+铁相比,结果相似。当母亲早期开始补充(<妊娠12周)并具有充足剂量(≥180个胶囊)时,与叶酸胶囊相比,复合微量元素胶囊与智商总量表评分升高2.16分(95% CI,0.41~3.90)和言语理解指数升高4.29分(95% CI,1.33~7.24)相关。在较晚开始补充(妊娠≥12周)且剂量不充分(<180个胶囊)的亚组中,平均测试分数较低。复合微量元素组比其他2个治疗组具有更高的评分,当与叶酸+铁相比时,智商总量表(调整平均差,2.46;95% CI,0.98~3.94)具有显着差异。

结论和意义:与叶酸+铁或叶酸胶囊补充相比,产前复合微量元素补充与青春期智力发育的增加相关;妊娠早期开始补充,然后继续补充至少180天,与最多的获益相关。

试验注册:isrctn.org Identifier: ISRCTN08850194.

原始出处:

Zhu Z, Cheng Y, Zeng L, et al. Association of Antenatal Micronutrient Supplementation With Adolescent Intellectual Development in Rural Western China: 14-Year Follow-up From a Randomized Clinical Trial. JAMA Pediatr. 2018 Sep 1;172(9):832-841. doi: 10.1001/jamapediatrics.2018.1401.

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    2019-08-11 feather89
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    2018-11-05 neurowu
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    2018-11-05 qilu_qi

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