Abstract：
Experimental data on the effects of lifestyle interventions on fetal neurodevelopment in humans remain scarce. This study assessed the impact of a pregnancy nutrition+exercise intervention on offspring neurodevelopment at 12 months of age. The Be Healthy in Pregnancy (BHIP) randomized controlled trial (RCT) randomly assigned pregnant persons with stratification by site and body mass index (BMI) to bi-weekly nutrition counselling and high dairy protein diet, walking goal of 10,000 steps/day plus usual prenatal care (UPC; intervention group) or UPC alone (control group). This study examined a subset of these mothers (> 18 years, singleton pregnancy, BMI <40 kg/m2, and enrolled by ≤12 weeks gestation) and their infants (intervention = 42, control = 32), assessing cognition, language, motor, social-emotional, and adaptive functioning at 12 months using the Bayley Scales of Infant and Toddler Development third edition (BSID-III) as the outcome measure. We also examined if maternal factors (prepregnancy BMI, gestational weight gain (GWG)) moderated associations. Expressive language (MD = 9.62, 95% CI = (9.05-10.18), p = 0.03, ƞ2p = 0.07) and general adaptive composite (GAC) scores (MD = 103.97, 95% CI = (100.31-107.63), p = 0.04, ƞ2p = 0.06) were higher in infants of mothers in the intervention group. Effect sizes were medium. However, mean cognitive, receptive language, motor, and social-emotional scale scores did not differ between groups. A structured and monitored nutrition+exercise intervention during pregnancy led to improved expressive language and general adaptive behavior in 12-month-olds, but not cognitive, receptive language, motor, or socioemotional functioning. While these experimental data are promising, further research is needed to determine the clinical utility of nutrition+exercise interventions for optimizing infant neurodevelopment.
摘要：
关于生活方式干预对人类胎儿神经发育影响的实验数据仍然很少。这项研究评估了怀孕营养+运动干预对12月龄后代神经发育的影响。怀孕期间健康（BHIP）随机对照试验（RCT）随机分配孕妇，按部位和体重指数（BMI）分层，每两周进行一次营养咨询和高乳制品蛋白饮食，步行目标为10,000步/天，加上常规的产前护理（UPC；干预组）或单独的UPC（对照组）。这项研究检查了这些母亲中的一部分(>18岁，单身怀孕,BMI<40kg/m2，并在≤12孕周纳入）及其婴儿（干预=42，对照组=32），评估认知，语言,电机,社会情感，以及12个月时的适应性功能，使用Bayley婴儿和幼儿发展量表第三版（BSID-III）作为结局指标。我们还检查了产妇因素(孕前BMI，妊娠期体重增加（GWG））缓和的关联。表达性语言(MD=9.62，95%CI=(9.05-10.18)，p=0.03，2p=0.07）和一般适应性复合（GAC）得分（MD=103.97，95％CI=（100.31-107.63），干预组母亲的婴儿p=0.04，2p=0.06）较高。效果大小为中等。然而,平均认知，接受语言,电机,社会情绪量表评分在组间没有差异.怀孕期间进行结构化和监测的营养运动干预可改善12个月儿童的表达语言和一般适应性行为，但不是认知，接受语言,电机,或社会情感功能。虽然这些实验数据很有希望，需要进一步的研究来确定营养+运动干预对优化婴儿神经发育的临床效用.
