生命历程理论框架下一项已随访20年出生队列的研究进展与展望

Research progress and prospects of a 20-year follow-up birth cohort study under the framework of life-course theory

摘要

基于一项关于孕期微营养素干预预防新生儿低出生体重的整群随机双盲对照试验,课题组建立了一项已随访20年的前瞻性出生队列,并在子代婴幼儿期(1、3、6、9、12、18、24和30月龄)、学龄早期(7～9岁)、青春早期(10～14岁)和青春晚期(18～22岁)进行了多次随访。该队列纵向、前瞻性地收集了入组对象的体格发育、心理健康、认知行为、社会适应、超声检测、生物样本等多维度健康结局和生命早期非常全面的暴露信息；在父母孕期暴露、孕期微营养素干预及子代生命早期喂养、发育轨迹等与健康结局的长短期效应方面已发表系列成果,为WHO修订孕期微营养素补充指南等提供了重要的循证数据。作为全球数据收集最完整的出生队列之一,结合生命历程理论,课题组有望建设成国内首项自孕期开始的生命历程队列；未来研究将基于多组学检测重点探讨生命早期关键暴露因素对子代健康的长期效应机制,识别健康干预的敏感窗口期,并将为成人慢性病的早期预防和落实“健康中国2030”、“健康陕西”全生命周期健康战略提供重要科学依据和循证方案。

Abstract

Based on a cluster-randomized, double-blind, controlled trial aimed to estimate the impact of maternal micronutrient supplementation on preventing low birthweight, our research team established a prospective birth cohort with a 20-year follow-up period. This cohort has undergone multiple follow-up assessments during infancy and early childhood (1, 3, 6, 9, 12, 18, 24, and 30 months of age), mid-childhood (7-9 years), early adolescence (10-14 years), and late adolescence (18-22 years). Longitudinal data on multidimensional health outcomes, including physical growth, mental health, cognitive development and behavioral problems, social adaptation, ultrasound measurements, and biospecimens, have been prospectively collected, along with comprehensive early-life exposures from multiple domains. Based on this cohort, we observed a series of findings on the short- and long-term effects of parental prenatal exposures, antenatal micronutrient supplementations, early-life infant feeding practices, and developmental trajectories on health outcomes, all of which provide important evidence for updating the WHO's guidelines on prenatal micronutrient supplementation. As one of the birth cohorts worldwide with detailed information, this study aligns with the life-course theory and has the potential to become China's first life-course cohort spanning from pregnancy. With ongoing multi-omics approaches today, future research will focus on elucidating the mechanisms by which key early-life exposures influence offspring life-course health, identifying sensitive windows for targeting interventions, and generating evidence-based strategies for the early prevention of adult chronic diseases. Taken together, these findings will support the implementation of the “Healthy China 2030” and “Healthy Shaanxi” initiatives, which eventually improve the population's life-course health.

关键词

出生队列 / 生命历程 / 妇幼健康及儿少卫生 / 多维度健康结局 / 慢性病的早期预防

Key words

birth cohort / life-course / maternal, child and adolescent health / multidimensional health outcome / early prevention of chronic diseases

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基金资助

国家自然科学基金资助项目(82103867)

中央高校基本科研业务费专项资金资助项目(xxj032025066)

陕西省重点研发计划项目(2024SF-YBXM-310)

陕西省创新能力支撑计划项目(2023-CX-PT-47)