Wesseling J, Van Driel D, Heymans H S, Van der Veer E, Sauer P J, Touwen B C, Smrkovsky M
Department of Paediatrics, Beatrix Children's Hospital, University Hospital Groningen, PO-Box 30.001, 9700 RB, Groningen, The Netherlands.
Early Hum Dev. 2000 Jun;58(3):213-24. doi: 10.1016/s0378-3782(00)00080-3.
In utero exposure to coumarin derivatives may affect the development of the central nervous system of the child, irrespective of the period of exposure in pregnancy. Little is known about effects on development in the long term. The aim of the present study was to determine whether prenatal exposure to coumarins affects behavioural outcome in children at school age. Behavioural outcome was assessed in a cohort of 305 exposed children, aged 7-15 years. Findings were compared with those in a cohort of 263 non-exposed controls, matched for sex, age, and demographic region. Behaviour was rated by parents and teachers using standardized questionnaires: the Groningen Behaviour Checklist Family situation (GBF) and the Groningen Behaviour Checklist School situation (GBS), respectively. The findings of the GBF were supported by the results of the GBS, filled in by teachers who were blind for the exposure status of the child. In comparison to the non-exposed children, the coumarin-exposed children scored lower on the cluster 'positive task orientation' (GBF P<0.05, GBS P<0.01), they scored higher on 'emotional instability' (GBF P<0.001, GBS P<0.05), and they had more problems on the social clusters (P<0.01). Based on the results of both questionnaires, we conclude that behavioural development may be negatively influenced in school-age children after in utero exposure to coumarins, leading to less favourable task-oriented and social-emotional behaviour. However, the frequency of clinically relevant 'problem behaviour' (GBF) was not increased in relation to coumarin exposure, the odds ratio was 1.2 (CI(95) 0.7-1.8).
子宫内接触香豆素衍生物可能会影响儿童中枢神经系统的发育，无论孕期接触的阶段如何。关于其对长期发育的影响知之甚少。本研究的目的是确定产前接触香豆素是否会影响学龄儿童的行为结果。对305名年龄在7至15岁的接触儿童进行了行为结果评估。将结果与263名未接触儿童的队列进行比较，后者在性别、年龄和人口统计学区域方面进行了匹配。父母和教师分别使用标准化问卷对行为进行评分：格罗宁根行为清单家庭情况（GBF）和格罗宁根行为清单学校情况（GBS）。GBF的结果得到了GBS结果的支持，GBS由对儿童接触状况不知情的教师填写。与未接触儿童相比，接触香豆素的儿童在“积极任务导向”类别中的得分较低（GBF P<0.05，GBS P<0.01），在“情绪不稳定”方面得分较高（GBF P<0.001，GBS P<0.05），并且在社交类别上存在更多问题（P<0.01）。根据两份问卷的结果，我们得出结论，子宫内接触香豆素后，学龄儿童的行为发育可能会受到负面影响，导致任务导向型和社会情感行为较差。然而，与香豆素接触相关的临床相关“问题行为”（GBF）的频率并未增加，优势比为1.2（CI(95) 0.7 - 1.8）。
