在一项纵向妊娠队列研究中，暴露于孕前超重和肥胖后幼儿执行功能的变化以及炎症的中介作用

IF 7.6 2区医学 Q1 IMMUNOLOGY

Brain, Behavior, and Immunity Pub Date : 2025-08-11 DOI:10.1016/j.bbi.2025.106075

Min Xu , Ping Zu , Shuang-Shuang Ma , Hai-Xia Wang , Nan Jiang , Jing-Feng Bian , Ji-Rong Xu , Wei Luo , Peng Zhu

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引用次数: 0

摘要

目的本研究旨在确定孕妇孕前超重和肥胖状况与幼儿执行功能（EF）发展之间的关系，并确定炎症生物标志物是否介导这种关系。方法前瞻性队列研究包括1126对母婴。从医疗记录中获取孕前体重指数（ppBMI），并根据标准的ppBMI分类将参与者分为正常体重组、超重组和肥胖组。使用学前执行功能行为评定量表（BRIEF-P）评估幼儿的EF得分，得分越高反映EF越差。采用线性回归模型比较正常体重母亲与超重和肥胖母亲的幼儿EF得分。使用SPSS PROCESS插件分析妊娠中期炎症生物标志物的中介作用。结果与孕前正常体重相比，孕前超重和肥胖与幼儿EF相关的行为障碍在抑制（β = 3.20, 95%可信区间[CI]: 0.92, 5.48）、移动（β = 3.12, 95% CI: 0.88, 5.36）、情绪控制（β = 3.44, 95% CI: 1.18, 5.71）、工作记忆（β = 4.17, 95% CI: 1.87, 6.47）和计划/组织（β = 3.19, 95% CI: 0.93, 5.45）等领域相关。对妊娠中期高敏c反应蛋白（hs-CRP）、肿瘤坏死因子α (TNF-α)和白细胞介素6 （IL-6）水平与幼儿EF的相关性分析表明，只有hs-CRP与EF呈正相关（Global Executive Composite score, β = 0.28, 95% CI: 0.07, 0.49）。中介分析显示，怀孕中期母亲hs-CRP水平介导了幼儿ppBMI与EF之间17.4%的关联，间接效应为0.75 (95% CI: 0.31, 1.24)，直接效应为3.56 （95% CI: 2.55, 4.58）。结论孕前超重和肥胖的孕妇更容易生下EF较差的幼儿，妊娠中期孕妇hs-CRP水平在一定程度上介导了这一关联。未来的研究应探讨改善妊娠合并超重的促炎代谢环境是否可以降低EF相关行为功能障碍增加的可能性。

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Variations in executive function in toddlers after exposure to pre-pregnancy overweight and obesity and the mediating role of inflammation in a longitudinal pregnancy cohort study

Objective

This study aimed to determine the association between pre-pregnancy overweight and obesity status in pregnant women and executive function (EF) development in toddlers and establish whether inflammatory biomarkers mediate this association.

Methods

This prospective cohort included 1,126 mother-infant pairs. Pre-pregnancy body mass index (ppBMI) was obtained from medical records, and the participants categorized into normal weight, overweight and obese groups according to standard ppBMI classifications. Toddlers’ EF scores were assessed using the Behaviour Rating Inventory of Executive Functioning Preschool Version (BRIEF-P), with higher scores reflecting worse EF. Linear regression models were used to compared EF scores between toddlers of normal weight mothers and those of overweight and obese mothers. The mediating effects of mid-pregnancy inflammatory biomarkers were analyzed using the SPSS PROCESS plug-in.

Results

Compared with pre-pregnancy normal weight, pre-pregnancy overweight and obesity was associated with EF related behavioral dysfunction in the domains of inhibition (β = 3.20, 95 % confidence interval [CI]: 0.92, 5.48), shifting (β = 3.12, 95 % CI: 0.88, 5.36), emotional control (β = 3.44, 95 % CI: 1.18, 5.71), working memory (β = 4.17, 95 % CI: 1.87, 6.47) and planning/organization (β = 3.19, 95 % CI: 0.93, 5.45) in toddlers. Analysis of the association between high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6) levels in mid-pregnancy and EF in toddlers demonstrated that only hs-CRP was positively associated with EF (Global Executive Composite score, β = 0.28, 95 % CI: 0.07, 0.49). Mediation analysis revealed that maternal hs-CRP levels in mid-pregnancy mediated 17.4 % of the association between ppBMI and EF in toddlers, with an indirect effect of 0.75 (95 % CI: 0.31, 1.24) and a direct effect of 3.56 (95 % CI: 2.55, 4.58).

Conclusions

Pregnant women with pre-pregnancy overweight and obesity were more likely to have toddlers with worse EF, and mid-pregnancy maternal hs-CRP levels partially mediated this association. Future studies should explore whether improving the pro-inflammatory metabolic milieu in pregnancies complicated by excess weight could reduce the likelihood of increased EF related behavioral dysfunction.

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来源期刊

Brain, Behavior, and Immunity 医学-免疫学

CiteScore

29.60

自引率

2.00%

发文量

290

审稿时长

28 days

期刊介绍： Established in 1987, Brain, Behavior, and Immunity proudly serves as the official journal of the Psychoneuroimmunology Research Society (PNIRS). This pioneering journal is dedicated to publishing peer-reviewed basic, experimental, and clinical studies that explore the intricate interactions among behavioral, neural, endocrine, and immune systems in both humans and animals. As an international and interdisciplinary platform, Brain, Behavior, and Immunity focuses on original research spanning neuroscience, immunology, integrative physiology, behavioral biology, psychiatry, psychology, and clinical medicine. The journal is inclusive of research conducted at various levels, including molecular, cellular, social, and whole organism perspectives. With a commitment to efficiency, the journal facilitates online submission and review, ensuring timely publication of experimental results. Manuscripts typically undergo peer review and are returned to authors within 30 days of submission. It's worth noting that Brain, Behavior, and Immunity, published eight times a year, does not impose submission fees or page charges, fostering an open and accessible platform for scientific discourse.