目的 探究孕期膳食多不饱和脂肪酸(PUFA)摄入与2岁幼儿神经心理发育之间的关联,为促进幼儿神经心理发育提供科学依据。方法 基于 2017年3月—2018年11月在广州市越秀区妇幼保健院建立的前瞻性出生队列,采用经过信效度检验的食物频率问卷调查孕中期妇女过去1个月的膳食摄入和营养素补充剂情况,依此计算孕期多不饱和脂肪酸的摄入量,采用年龄与发育进程问卷(ASQ-3)评估2岁幼儿的神经心理发育水平。采用多因素Logistic回归模型进行关联性分析。结果 共纳入261对母子。孕期n-6 PUFA、n-3 PUFA平均摄入量为17.59g/d和1.10g/d,n-6/n-3 PUFA比值为20.21。在校正混杂因素后,与最低四分位数组(Q1)相比,孕期较高的二十碳五烯酸(EPA)摄入与精细动作能区异常风险降低有关(OR=0.21,95%CI: 0.06~0.72,P＜0.05)、二十二碳六烯酸(DHA)摄入分别与沟通能区(OR=0.36,95%CI: 0.13~0.99)和个人-社会能区(OR=0.26,95%CI: 0.09~0.75)异常风险降低有关(P＜0.05)。孕期较高的总n-6 PUFA(OR=3.19,95%CI: 1.09~9.31)、亚油酸(LA)摄入(OR=3.28,95%CI: 1.13~5.85)与解决问题能区异常风险增加有关(P＜0.05)。高n-6/n-3 PUFA比值(OR=2.81,95%CI: 1.02~7.71;OR=3.83,95%CI: 1.18~12.50)、高LA/α-亚麻酸(ALA)比值(OR=3.04,95%CI: 1.10~8.42)与粗大动作和精细动作能区异常风险增加有关(P＜0.05)。未发现其他PUFA与2岁幼儿神经心理发育存在统计学关联(P>0.05)。结论 孕期增加膳食中DHA和EPA的摄入,合理控制n-6 PUFA和LA的摄入及n-6 PUFA与n-3 PUFA、LA与ALA的摄入比例,对改善幼儿的神经心理发育具有重要意义。
Abstract
Objective To explore the association between maternal dietary polyunsaturated fatty acid (PUFA) intake during pregnancy and neuropsychological development in 2-year-old children, in order to provide a scientific basis for promoting children's neuropsychological development. Methods Based on a prospective birth cohort established at the Yuexiu District Maternity and Child Health Care Hospital in Guangzhou from March 2017 to November 2018, a food frequency questionnaire with good reliability and validity was used to investigate the dietary intake and nutrient supplement use of women in the second trimester of pregnancy over the past month. Based on this information, the intake of PUFAs during pregnancy was calculated. The Ages and Stages Questionnaires, Third Edition (ASQ-3) was used to assess the neuropsychological development of 2-year-old children. Multivariable Logistic regression models were used for association analysis. Results A total of 261 mother-child pairs were included. The average intake of n-6 and n-3 PUFAs during pregnancy was 17.59g/d and 1.10g/d, respectively, with an n-6/n-3 PUFA ratio of 20.21. After adjusting for confounding factors, compared with the lowest quartile group (Q1), higher maternal intake of eicosapentaenoic acid (EPA) during pregnancy was associated with a reduced risk of abnormalities in the fine motor skills domain (OR=0.21, 95%CI: 0.06 - 0.72, P<0.05), and higher docosahexaenoic acid (DHA) intake was associated with reduced risks of abnormalities in the communication domain (OR=0.36, 95%CI: 0.13 - 0.99) and the personal-social domain (OR=0.26, 95%CI: 0.09 - 0.75), respectively (P<0.05). Higher total n-6 PUFA (OR=3.19, 95%CI: 1.09 - 9.31) and linoleic acid (LA) intake (OR=3.28, 95%CI: 1.13 - 5.85) during pregnancy were associated with an increased risk of abnormalities in the problem-solving domain (P<0.05). High n-6/n-3 PUFA ratios (OR=2.81, 95%CI: 1.02 - 7.71; OR=3.83, 95%CI: 1.18 - 12.50) and high LA/α-linolenic acid (ALA) ratios (OR=3.04, 95%CI: 1.10 - 8.42) were associated with an increased risk of abnormalities in the gross motor and fine motor skills domains (P<0.05). No statistical associations were found between other PUFAs and neuropsychological development in 2-year-old children(P>0.05). Conclusion Increasing maternal dietary intake of DHA and EPA during pregnancy and reasonably controlling the intake of n-6 PUFAs and LA, as well as the ratios of n-6 to n-3 PUFAs and LA to ALA, are of great significance for improving children's neuropsychological development.
关键词
多不饱和脂肪酸 /
神经心理发育 /
幼儿
Key words
polyunsaturated fatty acid /
neuropsychological development /
children
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基金
澳优-佳贝艾特营养科研基金(RS2023-08);广州市卫生健康科技项目(20251A011029);深圳市南山区科技创新项目(NS2022035)
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