曹晓敏, 李金玉, 刘成娟, 聂继盛. 母亲孕期多环芳烃暴露对其子女神经行为发育的影响[J]. 环境与职业医学, 2020, 37(6): 539-545. DOI: 10.13213/j.cnki.jeom.2020.19851
引用本文: 曹晓敏, 李金玉, 刘成娟, 聂继盛. 母亲孕期多环芳烃暴露对其子女神经行为发育的影响[J]. 环境与职业医学, 2020, 37(6): 539-545. DOI: 10.13213/j.cnki.jeom.2020.19851
CAO Xiao-min, LI Jin-yu, LIU Cheng-juan, NIE Ji-sheng. Effect of prenatal maternal exposure to polycyclic aromatic hydrocarbons on children's neurobehavioral development[J]. Journal of Environmental and Occupational Medicine, 2020, 37(6): 539-545. DOI: 10.13213/j.cnki.jeom.2020.19851
Citation: CAO Xiao-min, LI Jin-yu, LIU Cheng-juan, NIE Ji-sheng. Effect of prenatal maternal exposure to polycyclic aromatic hydrocarbons on children's neurobehavioral development[J]. Journal of Environmental and Occupational Medicine, 2020, 37(6): 539-545. DOI: 10.13213/j.cnki.jeom.2020.19851

母亲孕期多环芳烃暴露对其子女神经行为发育的影响

Effect of prenatal maternal exposure to polycyclic aromatic hydrocarbons on children's neurobehavioral development

  • 摘要: 背景

    多环芳烃是普遍存在于环境中的一种污染物,孕期多环芳烃暴露是不良神经行为发育的危险因素。

    目的

    探究母亲孕期多环芳烃暴露对其子女神经行为发育的影响。

    方法

    在太原市的两家医院共招募158对孕晚期的孕妇及其新生儿,并在其子女2岁时进行随访。待产孕妇住院后收集其产前尿样,儿童在2岁时随访并收集尿样,测定尿比重后,应用高效液相色谱-串联质谱法检测尿中11种多环芳烃羟基代谢物(OH-PAHs)。应用盖赛尔发育量表评估2岁儿童智力发育水平。盖塞尔发育量表主要分为动作能、言语能、应物能和应人能行为4个分量表,且每个分量表均可得到一个发育商数(DQ)。DQ的标准化值是100±15,通常DQ < 85被认为是发育迟缓;其中,DQ在70~84之间表示中度神经行为发育障碍,DQ < 70表示重度神经行为发育障碍。正态分布的连续性变量用x±s描述,非正态分布的连续性变量用MP25P75)或几何均数描述;分类变量用频数和构成比描述。应用限制性立方样条模型分析母亲孕期多环芳烃暴露与其子女2岁时的神经行为发育水平之间的剂量-反应关系,应用广义线性模型分析母亲孕期多环芳烃暴露对其子女2岁时神经行为发育的影响。

    结果

    2岁儿童的动作能、言语能、应物能和应人能行为的DQ分别是116.00±14.53、113.22±16.37、114.70±13.94和115.67±14.26;4项分量表中DQ < 85的分别有2、5、2和2人,其中言语能、应物能和应人能各有1人的DQ < 70。因孕妇尿中3-羟基䓛、6-羟基䓛和9-羟基苯并a芘的检出率低于50%,故仅对另8种OH-PAHs进行分析。其中,几何均数浓度以2-羟基菲为最高(0.09 μg·L-1),其次是2-羟基萘和1-羟基芘(均为0.07 μg·L-1)。孕妇尿中OH-PAHs总水平(ΣOH-PAHs)的几何均数是0.62 μg·L-1。调整混杂因素后,孕妇尿中的2-羟基萘与动作能DQ之间,ΣOH-PAHs与动作能DQ之间均存在剂量-反应关系。控制相关的混杂因素后,经自然对数转换后的2-羟基萘每增加一个单位,动作能DQ下降,其回归系数及其95%可信区间b(95%CI)为-1.41(-2.74~-0.08);经自然对数转换后的ΣOH-PAHs每增加一个单位,动作能DQ下降,其b(95%CI)为-2.09(-3.96~-0.21)。

    结论

    母亲孕期多环芳烃暴露与其子女2岁时神经行为发育水平降低存在关联性。

     

    Abstract: Background

    Polycyclic aromatic hydrocarbons are a common group of pollutants in the environment. Exposure to polycyclic aromatic hydrocarbons during pregnancy is a risk factor for adverse neurobehavioral development outcomes.

    Objective

    This study is designed to evaluate the association between maternal exposure to polycyclic aromatic hydrocarbons during pregnancy and children's neurobehavioral development.

    Methods

    A total of 158 mother-newborn pairs were collected from two hospitals in Taiyuan City, and the children were interviewed at age two. Urine samples were collected from the pregnant women waiting for delivery in hospital and the two-year-old children, and after the specific gravity of urine was measured, 11 urinary monohydroxylated polycyclic aromatic hydrocarbon metabolites (OH-PAHs) were detected by high performance liquid chromatography with tandem mass spectrometry. Children's neurobehavioral development was measured by Gesell Developmental Schedules. The Gesell Developmental Schedules consisted of four sub-scales:motor development, language development, adaptive behavior development, and personal-social behavior development, and each sub-scale generated a developmental quotient (DQ). DQ was standardized to 100±15; a DQ < 85 indicated growth retardation; a DQ of 70-84 indicated moderate neurobehavioral development disorder; a DQ < 70 indicated severe neurobehavioral development disorder. We used mean and standard deviation to describe continuous variables with normal distribution, median (interquartile range) or geometric mean (G) to describe continuous variables with skewed distribution, and frequency and proportion to describe categorical variables. Restricted cubic spline models were applied to assess the dose-response relationships between maternal prenatal polycyclic aromatic hydrocarbons exposure and children's neurobehavioral development at two years old. Generalized linear models were applied to evaluate the effect of exposure to maternal prenatal polycyclic aromatic hydrocarbons exposure on children's neurobehavioral development at two years old.

    Results

    The motor, language, adaptive, and personal-social DQs were 116.00±14.53, 113.22±16.37, 114.70±13.94, and 115.67±14.26, respectively. There were 2, 5, 2, and 2 children generating a DQ < 85 for the four sub-scales respectively, and there was 1 child with a DQ < 70 for the language sub-scale, 1 child with a DQ < 70 for the adaptive sub-scale, and 1 child with a DQ < 70 for the personal-social subscale. Because the positive rates of 3-hydroxychrysene, 6-hydroxychrysene, and 9-hydroxybenzoapyrene were all lower than 50%, the study included the other eight OH-PAHs for further analysis. The G level of 2-hydroxyphenanthrene was the highest (0.09 μg·L-1), followed by 2-hydroxynaphthalene (0.07 μg·L-1), and 1-hydroxypyrene (0.07 μg·L-1) in maternal urine. The G level of total OH-PAHs (ΣOH-PAHs) in maternal urine was 0.62 μg·L-1. After adjusting for selected confounding factors, there were dose-response associations between maternal urinary 2-hydroxynaphthalene and children's motor DQ as well as between ∑OH-PAHs and motor DQ; a unit increase in urinary ln (2-hydroxynaphthalene) (b=-1.41, 95%CI:-2.74--0.08) or ln (∑OH-PAHs) (b=-2.09, 95%CI:-3.96--0.21) was associated with a decrease in motor DQ.

    Conclusion

    Maternal exposure to polycyclic aromatic hydrocarbons during pregnancy is associated with decreased children's neurobehavioral development at two years old.

     

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