母亲孕早期血红蛋白水平与学龄前儿童智力发育的关系

杨雷; 任爱国; 刘建蒙; 叶荣伟; 洪世欣; 郑俊池

Abstract

杨雷,任爱国,刘建蒙,叶荣伟,洪世欣,郑俊池.母亲孕早期血红蛋白水平与学龄前儿童智力发育的关系[J].Chinese journal of Epidemiology,2010,31(12):1353-1358

母亲孕早期血红蛋白水平与学龄前儿童智力发育的关系

Influence of hemoglobin level during early gestation on the development of cognition of preschool children

Received:May 18, 2010

DOI：10.3760/cmad.issn.0254—6450.2010.12.007

KeyWord: 血红蛋白贫血孕早期智商学龄前儿童

English Key Word: Hemoglobin Anemia Early gestation Intelligence Pre—school children

FundProject:

Author Name	Affiliation	E-mail
Yang Lei	School of Public Health and Institute of Reproductive and Child Health,Peking University,Beijing 10Ol91,China
Ren Aiguo	School of Public Health and Institute of Reproductive and Child Health,Peking University,Beijing 10Ol91,China	renaiguo@gmail.com
Liu Jianmeng	School of Public Health and Institute of Reproductive and Child Health,Peking University,Beijing 10Ol91,China
Ye Rongwei	School of Public Health and Institute of Reproductive and Child Health,Peking University,Beijing 10Ol91,China
Hong Shixin	School of Public Health and Institute of Reproductive and Child Health,Peking University,Beijing 10Ol91,China
Zheng Junchi	School of Public Health and Institute of Reproductive and Child Health,Peking University,Beijing 10Ol91,China

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Abstract:

目的探讨母亲孕早期血红蛋白(Hb)水平对学龄前儿童智力发育的影响.方法研究对象为浙江、江苏省13市(县)在1993—1996年期间分娩的妇女,2000--2001年对这些妇女所生育的儿童(平均68月龄)随机抽样.共得到3609个母子对.使用中国一韦氏幼儿智力量表对儿童进行智力测试;母亲孕早期的Hb浓度在首次产前检查时获得.分析母亲孕早期Hb浓度与所生儿童全量表智商、语言智商和操作智商得分之间的关系.结果孕早期贫血组妇女所生儿童的语言智商、操作智商以及全量表智商得分,比非贫血组妇女所生儿童的智商得分分别高0.6、0.9和.8分.调整儿童性别、智力测量时月龄、地区、产次以及母亲智商、文化程度、职业等因素后,未发现母亲孕早期贫血与儿童低语言智商、操作智商和全量表智商的风险之间存在统计学联系.按照每20个百分位间隔将妊娠期妇女孕早期Hb分成5组分析,Hb浓度偏低组(Hb<103叽)、中等组/L一结论母亲孕早期过高的Hb浓度可能对其所生子女的语言智商有不利影响.

English Abstract:

0bjecfive The purpose of this study was to evaluate the effect of hemoglobin (1ib)level during early gestation on the cognitive development of children at 4—6 years of age． Methods A total number of 3609 children were randomly selected from all the live birth infants whose mothers participated in a community intervention trial during l 993—1 996 in l 3 counties or cities in Jiangsu and Zheiiang provinces．Hb concentration during early gestation was measured at first prenatal examination and intelligence quotients(IQ)，including full-scale，verbal and performance were assessed using Chinese．Wechsler Intelligence Scale for Children in 2000—2001 when these children had a mean age of 68 months．Results Compared with children whose mothers were non-anemic during early gestation。children whose mothers were anemic had a 0．6 point higher mean verbal scale tQ，a 0．9 point higher mean performance IQ and a 0．8 point higIler mean full—scale IQ． These differences were not statistically significant when children'S gender．age at intelligence test， region，parity and mother'S IQ．education level and occupation were adjusted for．、讹en motIler-child pairs were divided into 5 sub—groups of every 20 percentiles according to Hb concentration during early gestation，verbal IQ scores ofthe lowest(1ib<103 g，L)，the moderate(110 g，L≤Fib<116 g/L) and me llighest Hb concentration group(Hb≥124 g/L)were 91．6±18．9，92．8±18．2 and 90．3±18．6，respectively．The performance IQ scores were 104．7±15．2，104．5±14．3 and 103．5±15．1，and m11-scale IQ scores were 97．8±1 7．3，98．4±1 6．3 and 96．4±l 7．4，respectively．After controlling for confounding factors，children whose mothers had highest Hb concentration were 54％(OR=1．54， 95％a：1．13—2．11)more likely to have poor verbal scores and 53％(OR=1．53，95％C/：1．10—2．12) more likely to have poor full．scale scores岫ch/Idren whose mothers had moderate Hb concentration．No statisticaJ associations were noticed between high Hb concentration and performance scores。or between lOW Hb concentration during early gestation and verbal。performance as welI as full．scale score of pre-school children．Conclusion High matemal Hb concentration during early gestation might adversely affect children'S cognitive development．

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