妊娠相关焦虑对学龄前儿童执行功能的影响及性别差异

  目的  探讨母体妊娠相关焦虑对子代学龄前执行功能(EFs)的影响及性别差异，以期针对性优化子代生命早期发育环境。  方法  选取中国安徽出生队列2008年10月—2010年10月在安徽省马鞍山市妇幼保健院孕早期建卡的孕妇，收集孕妇一般情况和妊娠相关焦虑情况。对队列内的3 556名3~5岁儿童进行随访，收集儿童相关特征，采用《学龄前儿童执行功能评定量表》(父母版)评价其执行功能。  结果  与对照组相比，仅孕早期存在妊娠相关焦虑与学龄前男童工作记忆、计划/组织功能和总执行功能(GEC)异常风险有关OR 值(95%CI)分别为 1.40(1.06~1.85)，1.64(1.06~2.54)，1.89(1.27~2.82)]；孕早、晚期同时存在妊娠相关焦虑与学龄前男童抑制、工作记忆、计划/组织功能和 GEC 异常风险有关 OR值(95%CI)分别为 2.60(1.45~4.67)，2.45(1.69~3.57)，2.23(1.28~3.88)，3.27(2.03~5.28)]。 仅孕早期存在妊娠相关焦虑与学龄前女童抑制和工作记忆异常有关OR 值(95%CI)分别为 1.79(1.13~2.83)，1.45(1.07~1.98)]；仅孕晚期存在妊娠相关焦虑与学龄前女童抑制功能异常有关OR 值(95%CI)= 2.26(1.17~4.38)]；孕早、晚期同时存在妊娠相关焦虑与学龄前女童抑制和工作记忆功能异常风险有关OR 值(95%CI)分别为 2.45(1.40~4.28)，2.02(1.35~3.01)]。  结论  妊娠相关焦虑显著影响子代学龄前儿童执行功能，并存在剂量反应关系。妊娠相关焦虑在男童中主要影响工作记忆、计划/组织功能和总执行功能，在女童主要影响其工作记忆和抑制功能。

Effect of pregnancy-related anxiety on executive function of preschool children and gender difference

  Objective  To understand the effect of pregnancy-related anxiety on preschool children's executive functions(EFs) and gender difference in order to optimize the early development environment of offspring life.  Methods  This study was based on the China-Anhui Birth Cohort Study. Pregnant women from Maternal and Child Health Care Hospital in Ma'anshan, Anhui province between October 2008 and October 2010 were recruited. The general information of pregnant women and the pregnancy-related anxiety were collected prospectively in the first trimester of pregnancy. A cohort of 3 556 children aged 3-5 were followed up and their basic characteristics were collected. Executive function of preschool children was assessed by Behavior Rating Inventory of Executive Function-Preschool Version(BRIEF) (parent version).  Results  In boys compared with the control group pregnancy￣related anxiety in the first trimester of pregnancy was associated with the risk of abnormality in working memory planning/organization and GECOR(95%CI) = 1.40(1.06-1.85), 1.64(1.06-2.54), 1.89(1.27-2.82)]. Anxiety in the both trimesters of pregnancy was as-sociated with the risk of abnormality in inhibition working memory planning/organization and GECOR(95%CI) = 2.60(1.45-4.67), 2.45(1.69-3.57), 2.23(1.28-3.88), 3.27(2.03-5.28)] . In girls pregnancy-related anxiety in the first trimester of pregnancy was associated with the risk of abnormality in inhibition and working memory OR(95%CI) = 1.79(1.13-2.83), 1.45(1.07-1.98)] . Anxiety in the third trimester of pregnancy was associated with the risk of abnormality in inhibition OR(95%CI) = 2.26(1.17-4.38)] . Anxiety in both trimesters of pregnancy was associated with the risk of abnormality in inhibition and working memory OR(95%CI) = 2.45(1.40-4.28), 2.02(1.35-3.01)] .  Conclusion  Pregnancy-related anxiety significantly affected the executive function of preschool children, and there was a significant dose-response relationship. Pregnancy-related anxiety primarily affects working memory, planning/organization and GEC function in boys, and the working memory, inhibition function in girls.