Am J Clin Nutr:产前补充多种微量营养素,对后代生长和认知有什么影响?

2016-09-13 Mechront 译 MedSci原创

儿童营养不良也有可能是产前的原因,目前产前干预对儿童生长发育的影响尚不清楚。我们进行了研究,评估产前多种微量营养素(MM)补充剂对儿童成长和认知发育的影响。 这项随机对照试验在孟加拉进行,评估产前MM补充剂 vs 铁叶酸(IFA)补充剂,对后代出生到24个月期间的生长影响(n = 8529);使用贝利婴幼儿发展量表第三版对亚组(n = 734)进行了0-24个月的认知功能发育调查。 数

儿童营养不良也有可能是产前的原因,目前产前干预对儿童生长发育的影响尚不清楚。我们进行了研究,评估产前多种微量营养素(MM)补充剂对儿童成长和认知发育的影响。

这项随机对照试验在孟加拉进行,评估产前MM补充剂 vs 铁叶酸(IFA)补充剂,对后代出生到24个月期间的生长影响(n = 8529);使用贝利婴幼儿发展量表第三版对亚组(n = 734)进行了0-24个月的认知功能发育调查。

数据显示,MM组和IFA组生长迟缓(年龄相关身高z分数 (LAZ): <−2)发生率分别为31.9%和35.7%((P < 0.001);不过两组婴儿在头3-4个月时,LAZ增加。使用线性随机效应模型分析,产前MM暴露的儿童,相比LAZ组后代,其1个月和3个月的LAZ高出∼0.10,6个月时高出0.06。补充剂可降低1个月(RR: 0.95; 95% CI: 0.92, 0.98)和3个月(RR: 0.91; 95% CI: 0.88, 0.94)时的生长迟缓发生率。当后代6个月、12个月、以及24个月时,组间差异消失了;近50%的儿童生长迟缓。MM组与IFA组相比,从3个月到12个月,后代的出生体重和线性增长速度有所放缓,但是从12个月到24个月,该现象不复存在。在24个月大小,后代的认知、语言、运动复合评分方面,没有组间差异。

这项在孟加拉进行了的研究表明,产前和产后补充多种微量营养素,可以改善后代前三个月的LAZ,并且减少生长迟缓发生率;但是对后代2岁时的认知和运动功能等没有影响。

原始出处:

Parul Christian.et al.Effects of prenatal multiple micronutrient supplementation on growth and cognition through 2 years of age in rural Bangladesh: the JiVitA-3 Trial.Am J Clin Nutr ajcn135178; First published online September 7, 2016.

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    2016-09-15 qilu_qi
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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Wed Sep 14 14:17:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126666, encodeId=1a91126666ee, content=学习了,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Wed Sep 14 14:17:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126223, encodeId=45ea12622347, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44751723931, createdName=zac posen, createdTime=Tue Sep 13 11:11:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124618, encodeId=7b3f1246180e, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124619, encodeId=5a0b12461984, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-14 青龙偃月

    学习了,赞一个!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2016043, encodeId=a6e5201604367, content=<a href='/topic/show?id=3479508222b' target=_blank style='color:#2F92EE;'>#微量营养素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50822, encryptionId=3479508222b, topicName=微量营养素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c64275, createdName=piaojinhua, createdTime=Thu Jun 22 03:46:00 CST 2017, time=2017-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502486, encodeId=d1c8150248656, content=<a href='/topic/show?id=ef4b2441971' target=_blank style='color:#2F92EE;'>#产前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24419, encryptionId=ef4b2441971, topicName=产前)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-14 青龙偃月

    学习了,赞一个!

    0

  6. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-14 1dd8a7c5m95(暂无匿称)

    学习了,赞一个!!!

    0

  7. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-14 1dd8a7c5m95(暂无匿称)

    学习了,赞一个!!!

    0

  8. 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likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44751723931, createdName=zac posen, createdTime=Tue Sep 13 11:11:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124618, encodeId=7b3f1246180e, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124619, encodeId=5a0b12461984, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-13 zac posen

    哈哈哈哈哈哈哈哈

    0

  9. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-13 doctorJiangchao

    继续学习

    0

  10. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 13 10:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-13 doctorJiangchao

    继续关注

    0

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目的:孕妇补充多种微量营养素可以降低低出生体重儿风险,在中低收入国家一直推荐孕妇补充多种微量营养素以改善儿童生存、生长和健康。我们的目的是,对孕早期和中期开始补充多种微量营养素长期随访研究进行回顾。方法:干预包括≥3种微量营养素,对照组在可能的情况下服用铁(60 mg)和叶酸(400μG)。开始服用的中位数孕周从9-23周不等。主要结果是后代的死亡率、高、体重、头围。次要终点包括其他人体测量学指标