PDF(Pubmed)
Abstract：
Chewing betel quid (BQ) - a preparation commonly containing areca nut and slaked lime wrapped in betel leaf - is entrenched in South Asia. Although BQ consumption during pregnancy has been linked to adverse birth outcomes, its effect on postnatal growth remains largely unexplored.
We examined the associations of BQ use during pregnancy with children\'s height-for-age and body mass index-for-age z-scores (HAZ and BAZ, respectively) and fat and fat-free mass along with sex-based differences in association in rural Bangladesh.
With a prospective cohort design, we assessed BQ use among mothers enrolled in the Preterm and Stillbirth Study, Matlab (n = 3140) with a structured questionnaire around early third trimester. Children born to a subset of 614 women (including 134 daily users) were invited to follow-up between October 2021 and January 2022. HAZ and BAZ were calculated from anthropometric assessment, and fat and fat-free mass were estimated using bioelectric impedance. Overall and sex-specific multiple linear regression models were fitted.
Growth data were available for 501 children (mean age 4.9 years): 43.3% of them were born to non-users, 35.3% to those using prior to or less-than-daily during the survey, and 21.3% to daily users. No statistically significant associations were observed after adjusting for sex, parity, maternal height and education, and household wealth.
There was no effect of BQ use during pregnancy on postnatal growth in this study. Longitudinal studies following up those born to heavy users beyond childhood are warranted for capturing long-term implications of prenatal BQ exposure.
Main findings: In this cohort study, no association was observed between maternal betel quid use during pregnancy and children’s growth around five years of age.Added knowledge: Although catch-up growth among those born to heavy users may have attenuated any negative impact of prenatal exposure to betel quid on postnatal growth, such catch-up growth often involves greater acquisition and a more centralized distribution of body fat and insulin resistance later in life; leading to a potential heightening of cardiometabolic risk.Global health impact for policy and action: Given that betel quid consumption during pregnancy remains socially acceptable across south and south-east Asia, this study highlights the need for following up those born to betel quid users beyond childhood for capturing long-term health implications of prenatal betel quid exposure.
We examined the associations of BQ use during pregnancy with children\'s height-for-age and body mass index-for-age z-scores (HAZ and BAZ, respectively) and fat and fat-free mass along with sex-based differences in association in rural Bangladesh.
With a prospective cohort design, we assessed BQ use among mothers enrolled in the Preterm and Stillbirth Study, Matlab (n = 3140) with a structured questionnaire around early third trimester. Children born to a subset of 614 women (including 134 daily users) were invited to follow-up between October 2021 and January 2022. HAZ and BAZ were calculated from anthropometric assessment, and fat and fat-free mass were estimated using bioelectric impedance. Overall and sex-specific multiple linear regression models were fitted.
Growth data were available for 501 children (mean age 4.9 years): 43.3% of them were born to non-users, 35.3% to those using prior to or less-than-daily during the survey, and 21.3% to daily users. No statistically significant associations were observed after adjusting for sex, parity, maternal height and education, and household wealth.
There was no effect of BQ use during pregnancy on postnatal growth in this study. Longitudinal studies following up those born to heavy users beyond childhood are warranted for capturing long-term implications of prenatal BQ exposure.
Main findings: In this cohort study, no association was observed between maternal betel quid use during pregnancy and children’s growth around five years of age.Added knowledge: Although catch-up growth among those born to heavy users may have attenuated any negative impact of prenatal exposure to betel quid on postnatal growth, such catch-up growth often involves greater acquisition and a more centralized distribution of body fat and insulin resistance later in life; leading to a potential heightening of cardiometabolic risk.Global health impact for policy and action: Given that betel quid consumption during pregnancy remains socially acceptable across south and south-east Asia, this study highlights the need for following up those born to betel quid users beyond childhood for capturing long-term health implications of prenatal betel quid exposure.
摘要：
■咀嚼槟榔（BQ）-一种通常包含槟榔和槟榔叶包裹的熟石灰的制剂-在南亚根深蒂固。尽管怀孕期间的BQ消费与不良分娩结局有关，其对出生后生长的影响仍未被探索。
■我们检查了怀孕期间使用BQ与儿童的年龄身高和年龄体重指数z评分（HAZ和BAZ，分别），以及孟加拉国农村地区的脂肪和无脂肪质量以及基于性别的差异。
■通过前瞻性队列设计，我们评估了参加早产和死胎研究的母亲的BQ使用情况，Matlab（n=3140），并在孕晚期早期进行结构化问卷。在2021年10月至2022年1月期间，614名女性（包括134名每日使用者）所生的孩子被邀请进行随访。HAZ和BAZ是根据人体测量评估计算的，使用生物电阻抗估计脂肪和无脂肪质量。拟合总体和性别特异性多元线性回归模型。
■可获得501名儿童（平均年龄4.9岁）的生长数据：其中43.3％是非使用者出生的，35.3%的人在调查期间每天或每天以下使用，和21.3%的日常用户。在调整性别后，没有观察到统计学上显著的关联，奇偶校验，产妇身高和教育，家庭财富。
■在这项研究中，怀孕期间使用BQ对产后生长没有影响。有必要对那些在童年以后出生的重度使用者进行纵向研究，以捕获产前BQ暴露的长期影响。
主要发现：在这项队列研究中，孕妇在怀孕期间使用槟榔与5岁左右的儿童生长之间没有相关性.增加的知识：尽管重度使用者出生的人的追赶增长可能减轻了产前暴露于槟榔对出生后生长的任何负面影响，这种追赶增长通常涉及更多的获取和更集中的身体脂肪分布和胰岛素抵抗以后的生活;导致潜在的心脏代谢风险增加。全球健康对政策和行动的影响：鉴于怀孕期间的槟榔消费量在南亚和东南亚仍然是社会可以接受的，这项研究强调有必要对那些出生在童年以后的槟榔使用者进行跟踪，以捕捉产前槟榔暴露对健康的长期影响。
■我们检查了怀孕期间使用BQ与儿童的年龄身高和年龄体重指数z评分（HAZ和BAZ，分别），以及孟加拉国农村地区的脂肪和无脂肪质量以及基于性别的差异。
■通过前瞻性队列设计，我们评估了参加早产和死胎研究的母亲的BQ使用情况，Matlab（n=3140），并在孕晚期早期进行结构化问卷。在2021年10月至2022年1月期间，614名女性（包括134名每日使用者）所生的孩子被邀请进行随访。HAZ和BAZ是根据人体测量评估计算的，使用生物电阻抗估计脂肪和无脂肪质量。拟合总体和性别特异性多元线性回归模型。
■可获得501名儿童（平均年龄4.9岁）的生长数据：其中43.3％是非使用者出生的，35.3%的人在调查期间每天或每天以下使用，和21.3%的日常用户。在调整性别后，没有观察到统计学上显著的关联，奇偶校验，产妇身高和教育，家庭财富。
■在这项研究中，怀孕期间使用BQ对产后生长没有影响。有必要对那些在童年以后出生的重度使用者进行纵向研究，以捕获产前BQ暴露的长期影响。
主要发现：在这项队列研究中，孕妇在怀孕期间使用槟榔与5岁左右的儿童生长之间没有相关性.增加的知识：尽管重度使用者出生的人的追赶增长可能减轻了产前暴露于槟榔对出生后生长的任何负面影响，这种追赶增长通常涉及更多的获取和更集中的身体脂肪分布和胰岛素抵抗以后的生活;导致潜在的心脏代谢风险增加。全球健康对政策和行动的影响：鉴于怀孕期间的槟榔消费量在南亚和东南亚仍然是社会可以接受的，这项研究强调有必要对那些出生在童年以后的槟榔使用者进行跟踪，以捕捉产前槟榔暴露对健康的长期影响。
