Maternal Plasma 25-Hydroxyvitamin D during Gestation Is Positively Associated with Neurocognitive Development in Offspring at Age 4-6 Years.
Maternal Plasma 25-Hydroxyvitamin D during Gestation Is Positively Associated with Neurocognitive Development in Offspring at Age 4-6 Years.
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DOI：
10.1093/jn/nxaa309
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发表时间：
2020-11
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通讯作者：
Melissa M. Melough;Laura E. Murphy;J. Graff;Karen J Derefinko;K. LeWinn;N. Bush;D. Enquobahrie;C. Loftus;M. Koçak;S. Sathyanarayana;S. Sathyanarayana;F. Tylavsky
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作者：
Melissa M. Melough;Laura E. Murphy;J. Graff;Karen J Derefinko;K. LeWinn;N. Bush;D. Enquobahrie;C. Loftus;M. Koçak;S. Sathyanarayana;S. Sathyanarayana;F. Tylavsky
背景维生素D对胚胎神经元分化和其他可能影响未来神经认知功能的发育过程至关重要。然而，观察性研究发现，孕期维生素D和神经认知结果之间存在不一致的联系。目的研究孕期25-羟基维生素D[25(OH)D]与4-6岁儿童智商的关系，并探讨其相关性是否因种族而异。方法本研究使用的数据来自CANTLE(儿童早期神经认知发展和学习的影响条件)队列。在2006至2011年间，坎特尔招募了1503名健康单胎怀孕中期的女性。这项分析的纳入标准是≥孕周为34wk，以及25(OH)D和IQ数据的可用性。用多元线性回归分析孕中期25(OH)D血浆浓度与4-6岁子代斯坦福-比奈智商得分之间的关系；使用交互作用项来探索RACE可能的影响修正。结果1019例符合条件的双胎中，平均±SD25(OH)D浓度为21.6±8.4 ng/mL，平均孕周为23.0±3.0周。维生素D缺乏[25(OH)D及Lt；20 ng/mL]者占45.6%。黑人母体25(OH)D的平均值为19.8±7.2 ng/mL，白人为25.9±9.3 ng/mL(P<；0.001)。在调整后的模型中，25(OH)D每增加10 ng/毫升，总智商(95%CI：0.27，2.06分)增加1.17分，言语智商(95%CI：0.19，2.15分)增加1.17分，非语言智商(95%CI：0.10，1.95分)增加1.03分。我们没有观察到种族影响的证据。结论妊娠中期孕妇25(OH)D与4~6岁智商呈正相关，提示孕期维生素D状态可能是神经认知发育的重要预测指标。这些发现可能有助于为产前营养建议提供参考，并可能对黑人和其他维生素D缺乏风险较高的黑皮肤女性特别相关。
BACKGROUND Vitamin D is critical to embryonic neuronal differentiation and other developmental processes that may affect future neurocognitive function. However, observational studies have found inconsistent associations between gestational vitamin D and neurocognitive outcomes. OBJECTIVES We examined the association of gestational 25-hydroxyvitamin D [25(OH)D] with children's IQ at 4-6 y, and explored whether associations differed by race. METHODS This study used data from the CANDLE (Conditions Affecting Neurocognitive Development and Learning in Early Childhood) cohort. Between 2006 and 2011, CANDLE recruited 1503 women in their second trimester of healthy singleton pregnancies. Inclusion criteria for this analysis were gestation of ≥34 wk and availability of 25(OH)D and IQ data. Associations between second-trimester 25(OH)D plasma concentration and Stanford-Binet IQ scores in offspring at 4-6 y were examined using multivariable linear regression; interaction terms were used to explore possible effect modification by race. RESULTS Mean ± SD 25(OH)D concentration among 1019 eligible dyads was 21.6 ± 8.4 ng/mL, measured at a mean ± SD gestational age of 23.0 ± 3.0 wk. Vitamin D deficiency [25(OH)D < 20 ng/mL] was observed in 45.6%. Maternal 25(OH)D differed by race with a mean ± SD of 19.8 ± 7.2 ng/mL in Blacks sand 25.9 ± 9.3 ng/mL in Whites ( P < 0.001). In adjusted models a 10-ng/mL increase in 25(OH)D was associated with a 1.17-point higher Full Scale IQ (95% CI: 0.27, 2.06 points), a 1.17-point higher Verbal IQ (95% CI: 0.19, 2.15 points), and a 1.03-point higher Nonverbal IQ (95% CI: 0.10, 1.95 points). We observed no evidence of effect modification by race. CONCLUSIONS Second-trimester maternal 25(OH)D was positively associated with IQ at 4-6 y, suggesting that gestational vitamin D status may be an important predictor of neurocognitive development. These findings may help inform prenatal nutrition recommendations and may be especially relevant for Black and other dark-skinned women at high risk of vitamin D deficiency.