Maternal pregnancy-related anxiety and children's physical growth: the Ma'anshan birth cohort study

Authors：Jixing Zhou, Shanshan Zhang, Yuzhu Teng, Jingru Lu, Yufan Guo, Shuangqin Yan, Fangbiao Tao, Kun Huang

Source：BMC Pregnancy Childbirth. 2023 May 25;23(1):384

DOI: 10.1186/s12884-023-05711-5

Abstract：

Background: Epidemiological studies have identified maternal antenatal anxiety and several adverse birth outcomes, but limited studies have focused on the relationship with the long-term physical growth of children. The study aimed to assess the influence of maternal pregnancy-related anxiety on physical growth in children at different exposure periods during pregnancy.

Methods: 3,154 mother-child pairs were included based on the Ma'anshan birth cohort study. Maternal prenatal anxiety was obtained by administering a questionnaire using the pregnancy-related anxiety questionnaire (PRAQ) scale during the 1st, 2nd and 3rd trimesters of pregnancy. Body fat (BF) (48 to 72 months) and Body Mass Index (BMI) (birth to 72 months) were collected repeatedly for children. Group-based trajectory models were applied to fit the different trajectories of BMI and BF.

Results: Maternal anxiety in the 2nd (OR = 0.81; 95% CI: 0.68 to 0.98; P < 0.025) and 3rd (OR = 0.80; 95% CI: 0.67 to 0.97; P = 0.020) trimesters was associated with a decreased risk of rapid weight gain (RWG) in the first year of life. Children aged 48 to 72 months of mothers with anxiety in the 3rd trimester had lower BMI (β = -0.161; 95% CI, -0.293 to -0.029; P = 0.017) and BF (β = -0.190; 95% CI, -0.334 to -0.046; P = 0.010), and these children were less likely to develop a very high BMI trajectory (OR = 0.54; 95% CI: 0.34 to 0.84; P = 0.006), and a high BF trajectory (OR = 0.72; 95% CI: 0.53 to 0.99; P = 0.043). Similar associations were found between maternal anxiety in both 2nd and 3rd trimesters and children's physical growth.

Conclusions: Offspring of mothers with prenatal anxiety in the 2nd and 3rd trimesters predicts poorer growth in infancy and preschool age. Early improvement and treatment of prenatal anxiety could benefit physical health and development in early childhood.

Keywords: Body fat; Body mass index; Children; Cohort; Pregnancy-related anxiety.

中文摘要：

背景：流行病学研究已经确定了产妇产前焦虑和几种不良分娩结局，但有限的研究聚焦于与儿童长期身体发育的关系。该研究旨在评估不同孕期母体焦虑对儿童身体发育的影响。

方法：根据马鞍山出生队列研究，纳入3，154对母子。通过在孕早、中、晚期使用妊娠相关焦虑问卷（PRAQ）量表进行问卷调查，获得产妇产前焦虑。重复收集儿童体脂（BF）（48至72个月）和体重指数（BMI）（出生至72个月）。应用基于组的轨迹模型来拟合BMI和BF的不同轨迹。

结果：孕中期（OR = 2.0；81% CI：95.0-68.0；P < 98.0）和孕晚期产妇焦虑（OR = 3.0；80% CI： 95.0 至 67.0；P = 97.0）与出生后第一年体重快速增加（RWG）的风险降低有关。母亲在妊娠晚期焦虑的48-72个月儿童具有较低的BMI（β = -72.3；0%CI，-161.95至-0.293；P = 0.029）和BF（β = -0.017；0%CI，-190.95至-0.334；P = 0.046），而且这些儿童不太可能出现非常高的BMI轨迹（OR = 0.010；0%CI：54.95至0.34；P = 0.84）和BF 轨迹（OR = 0.006；0% CI：72.95 至 0.53；P = 0.99）。孕中期和孕晚期的母亲焦虑与儿童的身体发育之间也发现了类似的关联。

结论：孕中期和孕晚期产前焦虑母亲的后代预测在婴儿期和学龄前期的生长较差。产前焦虑的早期改善和治疗有益于儿童早期的身体健康和发育。

关键字：体脂；体重指数；儿童；队列；孕期焦虑。