Socioeconomic disadvantage and neural development from infancy through early childhood
Socioeconomic disadvantage and neural development from infancy through early childhood
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DOI：
10.1093/ije/dyv303
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发表时间：
2015-12-01
影响因子：
7.7
通讯作者：
Gilman, Stephen E.
中科院分区：
文献类型：
--
作者：
Hung, Galen Chin-Lun;Hahn, Jill;Gilman, Stephen E.
背景：早期的社会经历被认为会影响神经发育，并可能对一生产生影响。然而，关于社会环境对儿童神经功能（神经发育的核心领域）的作用的证据很少。方法：我们分析了美国围产期合作项目36443名参与者的数据，该项目是1959年至1974年间开展的一个社会经济多样化的妊娠队列。研究结果包括：医生（神经科医生或儿科医生）评定的新生儿及其后4个月、1岁和7岁的神经异常；神经系统硬、软体征指标；自主神经系统功能指标。结果：社会经济条件不利的父母所生的儿童在4个月时更容易出现神经系统异常[比值比(OR) = 1.20；95%可信区间(CI) = 1.06, 1.37]， 1年（OR = 1.35; CI = 1.17, 1.56）和7年（OR = 1.67; CI = 1.48, 1.89）， 7岁时更容易出现神经硬体征（OR = 1.39; CI = 1.10, 1.76），软体征（OR = 1.26; CI = 1.09, 1.45）和自主神经系统功能障碍。妊娠和分娩并发症本身与社会经济劣势相关，但不能解释弱势儿童神经异常风险较高的原因。结论：父母的社会经济劣势与儿童7岁前神经发育异常无关，与妊娠和分娩并发症无关。这些发现强化了早期环境对神经发育的重要性，并扩展了有关环境条件影响神经发育领域的知识。需要进一步的工作来确定将社会经济劣势与儿童神经功能联系起来的机制，这种机制的时间和它们的潜在可逆性。
Background: Early social experiences are believed to shape neurodevelopment, with potentially lifelong consequences. Yet minimal evidence exists regarding the role of the social environment on children's neural functioning, a core domain of neurodevelopment.Methods: We analysed data from 36 443 participants in the United States Collaborative Perinatal Project, a socioeconomically diverse pregnancy cohort conducted between 1959 and 1974. Study outcomes included: physician (neurologist or paediatrician)-rated neurological abnormality neonatally and thereafter at 4 months and 1 and 7 years; indicators of neurological hard signs and soft signs; and indicators of autonomic nervous system function.Results: Children born to socioeconomically disadvantaged parents were more likely to exhibit neurological abnormalities at 4 months [odds ratio (OR) = 1.20; 95% confidence interval (CI) = 1.06, 1.37], 1 year (OR = 1.35; CI = 1.17, 1.56), and 7 years (OR = 1.67; CI = 1.48, 1.89), and more likely to exhibit neurological hard signs (OR = 1.39; CI = 1.10, 1.76), soft signs (OR = 1.26; CI = 1.09, 1.45) and autonomic nervous system dysfunctions at 7 years. Pregnancy and delivery complications, themselves associated with socioeconomic disadvantage, did not account for the higher risks of neurological abnormalities among disadvantaged children.Conclusions: Parental socioeconomic disadvantage was, independently from pregnancy and delivery complications, associated with abnormal child neural development during the first 7 years of life. These findings reinforce the importance of the early environment for neurodevelopment generally, and expand knowledge regarding the domains of neurodevelopment affected by environmental conditions. Further work is needed to determine the mechanisms linking socioeconomic disadvantage with children's neural functioning, the timing of such mechanisms and their potential reversibility.