Пренатальные и перинатальные факторы риска нарушений интеллектуального и речевого развития ребенка: нарративный обзор литературы и результаты ретроспективного анализа

Речевые навыки и уровень интеллекта являются решающими в определении успешности человека в различных сферах жизни. Данные многочисленных исследований о влиянии пре- и перинатальных факторов на нейрокогнитивное развитие детей остаются противоречивыми, несмотря на то что знания в этой области потенциально имеют важное практическое значение. В данной статье представлен нарративный обзор современной литературы о влиянии пре-и перинатальных факторов на речевое и интеллектуальное развитие детей, а также результаты собственного ретроспективного исследования выборки детей старшего дошкольного возраста из Нижегородского региона России. Получены данные об отрицательной ассоциации преждевременных родов, гестационного сахарного диабета, угрозы прерывания беременности, родоразрешения путем кесарева сечения, артериальной гипертензии при беременности с речевым и интеллектуальным развитием ребенка. Учет этих факторов на ранних этапах онтогенеза (в дошкольном возрасте) и своевременная коррекция речевых и интеллектуальных функций могут способствовать профилактике школьной неуспеваемости и повышению адаптации ребенка в академической среде.

1. Sun X., Liu C., Ji H., Li W., Miao M., Yuan W., Yuan Z., Liang H., Kan H. Prenatal exposure to ambient PM2.5 and its chemical constituents and child intelligence quotient at 6 years of age. Ecotoxicol. Environ Saf. 2023;255:114813. doi: 10.1016/j.ecoenv.2023.114813

2. Mahabee-Gittens E.M., Harun N., Glover M., Folger A.T., Parikh N.A.; Cincinnati Infant Neurodevelopment Early Prediction Study (CINEPS) Investigators. Prenatal tobacco smoke exposure and risk for cognitive delays in infants born very premature. Sci. Rep. 2024;14(1):1397. doi: 10.1038/s41598-024-51263-9

3. Calder S.D., Brennan-Jones C.G., Robinson M., Whitehouse A., Hill E. The prevalence of and potential risk factors for developmental language disorder at 10 years in the raine study. J. Paediatr. Child. Health. 2022;58(11):2044–2050. doi: 10.1111/jpc.16149

4. Whitehouse A.J., Robinson M., Li J., Oddy W.H. Duration of breast feeding and language ability in middle childhood. Paediatr. Perinat. Epidemiol. 2011;25(1):44–52. doi: 10.1111/j.1365-3016.2010.01161.x

5. Tomblin J.B., Hammer C.S., Zhang X. The association of parental tobacco use and SLI. Int. J. Lang. Commun. Disord. 1998;33(4):357–368. doi: 10.1080/136828298247686

6. Cortes Hidalgo A.P., Neumann A., Bakermans-Kranenburg M.J., Jaddoe V.W.V., Rijlaarsdam J., Verhulst F.C., White T., van Ijzendoorn M.H., Tiemeier H. Prenatal maternal stress and child IQ. Child. Dev. 2020;91(2):347–365. doi: 10.1111/cdev.13177

7. Veldkamp S.A.M., Zondervan-Zwijnenburg M.A.J., van Bergen E., Barzeva S.A., TamayoMartinez N., Becht A.I., van Beijsterveldt C.E.M., Meeus W., Branje S., Hillegers M.H.J., … Hartman C. Parental age in relation to offspring’s neurodevelopment. J. Clin. Child Adolesc. Psychol. 2021;50(5):632– 644. doi: 10.1080/15374416.2020.1756298

8. Wan W., Zhu Y., Tian J., Cheng Y., Zeng L., Zhu Z. Associations of parental age at pregnancy with adolescent cognitive development and emotional and behavioural problems: a birth cohort in rural Western China. BMC Public Health. 2024;24(1):775. doi: 10.1186/s12889-024-18309-z

9. Du J., Rolls E.T., Gong W., Cao M., Vatansever D., Zhang J., Kang J., Cheng W., Feng J. Association between parental age, brain structure, and behavioral and cognitive problems in children. Mol. Psychiatry. 2022;27(2):967–975. doi: 10.1038/s41380-021-01325-5

10. Caffrey A., McNulty H., Rollins M., Prasad G., Gaur P., Talcott J.B., Witton C., Cassidy T., Marshall B., Dornan J., … Pentieva K. Effects of maternal folic acid supplementation during the second and third trimesters of pregnancy on neurocognitive development in the child: an 11-year follow-up from a randomised controlled trial. BMC Med. 2021;19(1):73. doi: 10.1186/s12916-021-01914-9

11. Hunter S.K., Hoffman M.C., D’Alessandro A., Walker V.K., Balser M., Noonan K., Law A.J., Freedman R. Maternal prenatal choline and inflammation effects on 4-year-olds’ performance on the Wechsler Preschool and Primary Scale of Intelligence-IV. J. Psychiatr. Res. 2021;141:50–56. doi: 10.1016/j.jpsychires.2021.06.037

12. Hrezova E., Jiskrova G.K., Prusa T., Andryskova L., Pikhart H. Vitamin B12 intake during pregnancy linked to child speech development and intelligence quotient. J. Public Health (Oxf). 2025;47(1):34–44. doi: 10.1093/pubmed/fdae307

13. Cruz-Rodríguez J., Canals-Sans J., HernándezMartínez C., Voltas-Moreso N., Arija V. Prenatal vitamin B12 status and cognitive functioning in children at 4 years of age: The ECLIPSES Study. Matern. Child Nutr. 2024;20(1):e13580. doi: 10.1111/mcn.13580

14. Liu Y., Zhong L., Sun Z., Feng Y., Ding Q., Zhang Y. N-3 fatty acid supplementation in mothers and infants for childhood psychomotor and cognitive development: an updated systematic review and metaanalysis. Matern. Child Nutr. 2025;21(2):e13767. doi: 10.1111/mcn.13767

15. Moumin N.A., Shepherd E., Liu K., Makrides M., Gould J.F., Green T.J., Grzeskowiak L.E. The effects of prenatal iron supplementation on offspring neurodevelopment in upper middle- or high-income countries: a systematic review. Nutrients. 2024;16(15):2499. doi: 10.3390/nu16152499

16. Whitehouse A.J., Shelton W.M., Ing C., Newnham J.P. Prenatal, perinatal, and neonatal risk factors for specific language impairment: a prospective pregnancy cohort study. J. Speech Lang. Hear. Res. 2014;57(4):1418–1427. doi: 10.1044/2014_JSLHRL-13-0186

17. Devaraju M., Li A., Ha S., Li M., Shivakumar M., Li H., Nishiguchi E.P., Gérardin P., Waldorf K.A., Al-Haddad B.J.S. Beyond TORCH: A narrative review of the impact of antenatal and perinatal infections on the risk of disability. Neurosci. Biobehav. Rev. 2023;153:105390. doi: 10.1016/j.neubiorev.2023.105390

18. Lee Y.H., Papandonatos G.D., Savitz D.A., Heindel W.C., Buka S.L. Effects of prenatal bacterial infection on cognitive performance in early childhood. Paediatr. Perinat. Epidemiol. 2020;34(1):70–79. doi: 10.1111/ppe.12603

19. Kwok J., Hall H.A., Murray A.L., Lombardo M.V., Auyeung B. Maternal infections during pregnancy and child cognitive outcomes. BMC Pregnancy Childbirth. 2022;22(1):848. doi: 10.1186/s12884-022-05188-8

20. Antoun S., Ellul P., Peyre H., Rosenzwajg M., Gressens P., Klatzmann D., Delorme R. Fever during pregnancy as a risk factor for neurodevelopmental disorders: results from a systematic review and meta-analysis. Mol. Autism. 2021;12(1):60. doi: 10.1186/s13229-021-00464-4

21. Liu X., Zhu Y., Seamans M., Nianogo R., Janzen C., Fei Z., Chen L. Gestational diabetes mellitus and risk of neurodevelopmental disorders in young offspring: does the risk differ by race and ethnicity? Am. J. Obstet. Gynecol. MFM. 2024;6(1):101217. doi: 10.1016/j.ajogmf.2023.101217

22. Ornoy A., Becker M., Weinstein-Fudim L., Ergaz Z. Diabetes during pregnancy: a maternal disease complicating the course of pregnancy with longterm deleterious effects on the offspring. A clinical review. Int. J. Mol. Sci. 2021;22(6):2965. doi: 10.3390/ijms22062965

23. Noda M., Yoshida S., Mishina H., Matsubayashi K., Kawakami K. Association between maternal hypertensive disorders of pregnancy and child neurodevelopment at 3 years of age: a retrospective cohort study. J. Dev. Orig. Health Dis. 2021;12(3):428–435. doi: 10.1017/S2040174420000586

24. Jin J.H., Yoon S.W., Song J., Kim S.W., Chung H.J. Long-term cognitive, executive, and behavioral outcomes of moderate and late preterm at school age. Clin. Exp. Pediatr. 2020;63(6):219–225. doi: 10.3345/kjp.2019.00647

25. Lacalle L., Martínez-Shaw M.L., Marín Y., Sánchez-Sandoval Y. Intelligence Quotient (IQ) in school-aged preterm infants: A systematic review. Front. Psychol. 2023;14:1216825. doi: 10.3389/fpsyg.2023.1216825

26. Pierrat V., Marchand-Martin L., Marret S., Arnaud C., Benhammou V., Cambonie G., Debillon T., Dufourg M.N., Gire C., Goffinet F., … Ancel P.Y. EPIPAGE-2 writing group. Neurodevelopmental outcomes at age 5 among children born preterm: EPIPAGE-2 cohort study. BMJ. 2021;373:n741. doi: 10.1136/bmj.n741

27. Jensen A., Rochow N., Voigt M., Neuhäuser G. Differential effects of growth restriction and immaturity on predicted psychomotor development at 4 years of age in preterm infants. AJOG Glob. Rep. 2024;4(1):100305. doi: 10.1016/j.xagr.2023.100305

28. Chin W.C., Wu W.C., Hsu J.F., Tang I., Yao T.C., Huang Y.S. Correlation analysis of attention and intelligence of preterm infants at preschool age: a premature cohort study. Int. J. Environ. Res. Public Health. 2023;20(4):3357. doi: 10.3390/ijerph20043357

29. Eves R., Mendonça M., Baumann N., Ni Y., Darlow B.A., Horwood J., Woodward L.J., Doyle L.W., Cheong J., Anderson P.J., … Wolke D. Association of very preterm birth or very low birth weight with intelligence in adulthood: an individual participant data meta-analysis. JAMA Pediatr. 2021;175(8):e211058. doi: 10.1001/jamapediatrics.2021.1058

30. Kim E.S., Kim E.K., Kim S.Y., Song I.G., Jung Y.H., Shin S.H., Kim H.S., Kim J.I., Kim B.N., Shin M.S. cognitive and behavioral outcomes of school-aged children born extremely preterm: a korean single-center study with long-term follow-up. J. Korean Med. Sci. 2021;36(39):e260. doi: 10.3346/jkms.2021.36.e260

31. Kim H.S., Kim E.K., Park H.K., Ahn D.H., Kim M.J., Lee H.J. Cognitive outcomes of children with very low birth weight at 3 to 5 years of age. J. Korean Med. Sci. 2020;35(1):e4. doi: 10.3346/jkms.2020.35.e4

32. Stipdonk L.W., Dudink J., Utens E.M.W.J., Reiss I.K., Franken M.J.P. Language functions deserve more attention in follow-up of children born very preterm. Eur. J. Paediatr. Neurol. 2020;26:75–81. doi: 10.1016/j.ejpn.2020.02.004

33. Balázs A., Lakatos K., Harmati-Pap V., Tóth I., Kas B. The influence of temperament and perinatal factors on language development: a longitudinal study. Front. Psychol. 2024;15:1375353. doi: 10.3389/fpsyg.2024.1375353

34. Sanchez K., Spittle A.J., Cheong J.L., Thompson D.K., Doyle L.W., Anderson P.J., Morgan A.T. Language in 2-year-old children born preterm and term: a cohort study. Arch. Dis. Child. 2019;104(7):647–652. doi: 10.1136/archdischild-2018-315843

35. Blake J.A., Gardner M., Najman J., Scott J.G. The association of birth by caesarean section and cognitive outcomes in offspring: a systematic review. Soc. Psychiatry Psychiatr. Epidemiol. 2021;56(4):533–545. doi: 10.1007/s00127-020-02008-2

36. Ladelund A.K., Slavensky J.A., Bruun F.J., Fogtmann Sejer E.P., Mortensen E.L., Ladelund S., Kesmodel U.S. Association of birth by cesarean section with academic performance and intelligence in youth: A cohort study. Acta Obstet. Gynecol. Scand. 2023;102(5):532–540. doi: 10.1111/aogs.14535

37. Lima A.B.S., Martins Neto C., Ferraro A.A., Barbieri M.A., Simões V.M.F. Cesarean section and association with intelligence quotient in adolescents: contribution from the RPS Cohort Consortium (Ribeirão Preto, Pelotas and São Luís), Brazil. Cad. Saude Publica. 2023;39(3):e00064422. doi: 10.1590/0102-311XPT064422

38. González-Valenzuela M.J., López-Montiel D., Cazorla-Granados O., González-Mesa E. Type of delivery and reading, writing, and arithmetic learning in twin births. Dev. Psychobiol. 2020;62(4):484–495. doi: 10.1002/dev.21932

39. Whitehouse A.J., Robinson M., Li J., Oddy W.H. Duration of breast feeding and language ability in middle childhood. Paediatr. Perinat. Epidemiol. 2011;25(1):44–52. doi: 10.1111/j.1365-3016.2010.01161.x

40. Guzzardi M.A., Granziera F., Sanguinetti E., Ditaranto F., Muratori F., Iozzo P. Exclusive breastfeeding predicts higher hearing-language development in girls of preschool age. Nutrients. 2020;12(8):2320. doi: 10.3390/nu12082320

41. Check J., Shuster C., Hofheimer J., Camerota M., Dansereau L.M., Smith L.M., Carter B.S., DellaGrotta S.A., Helderman J., Kilbride H., … Lester B.M. Preeclampsia, fetal growth restriction, and 24-month neurodevelopment in very preterm infants. JAMA Netw. Open. 2024;7(7):e2420382. doi: 10.1001/jamanetworkopen.2024.20382

42. Роид Г.Х., Миллер Л.Дж., Помплан М., Кох К. Международные шкалы продуктивности Леитер-3, третье издание. Руководство. Джунти Психометрикс, 2014.

43. Гомозова М.А., Арутюнян В.Г., Лопухина А.А., Драгой О.В. Инструмент для комплексного обследования речевых навыков КОРАБЛИК и опыт его применения в группе младших школьников с РАС. Аутизм и нарушения развития. 2021;19(4):24– 31. doi: 10.17759/autdd.2021190403.