Stewart Paul W, Reihman Jacqueline, Lonky Edward I, Darvill Thomas J, Pagano James
Department of Psychology, State University of New York at Oswego, Oswego, NY 13126, USA.
Neurotoxicol Teratol. 2003 Jan-Feb;25(1):11-22. doi: 10.1016/s0892-0362(02)00320-3.
A number of epidemiological studies have shown predictive relationships between prenatal exposure to polychlorinated biphenyls (PCBs) and subtle deficits in cognitive development in infancy through the preschool years [Child Dev. 56 (1985) 853; J. Pediatr. 116 (1990) 38; J. Pediatr. 134 (1999) 33; Toxicol. Lett. 102-103 (1998) 423; Neurotox. 21 (6) (2000) 1029-1038]. However, since not all studies have demonstrated these relationships (J. Pediatr. 119 (1991) 58-63), debate regarding the role of prenatal PCB exposure in cognitive development continues. The current study was designed to provide additional data to assist in resolving this question. Two hundred twelve children enrolled in the Oswego Newborn and Infant Development Project were assessed using the McCarthy Scales of Children's Abilities at 38 months of age, followed by a reassessment at 54 months of age. The relationship between prenatal exposure to PCBs (cord blood PCBs) and McCarthy performance was assessed at both ages after first controlling for a wide range of important predictors of cognitive development, including socioeconomic status (SES), maternal IQ, maternal education, home environment, cigarette smoking, and many others. Cord blood PCBs were statistically significant predictors of small but measurable deficits in McCarthy performance at 38 months of age. Moreover, a significant interaction between cord blood PCBs and maternal hair mercury (MeHg) was found, such that negative associations between prenatal MeHg exposure and McCarthy performance were found in subjects with higher levels of prenatal PCB exposure. No relationship between PCBs and/or MeHg and McCarthy performance was observed when the children were reassessed almost 1.5 years later (54 months of age). Inspection of the age-related trajectory of McCarthy performance revealed that the more highly exposed children caught up with the least exposed children by 54 months. Although the current data partially replicate the findings of Jacobson et al., Patandin et al., and Walkowiak et al. [J. Pediatr. 116 (1990) 38; J. Pediatr. 134 (1999) 33; Lancet 358 (2001) 1602], results reported here suggest that functional recovery may occur. Moreover, the interaction between PCB and MeHg cannot be considered conclusive until it has been replicated in subsequent investigations.
多项流行病学研究表明,产前接触多氯联苯(PCBs)与婴儿期至学龄前儿童认知发展的细微缺陷之间存在预测关系[《儿童发展》56卷(1985年)第853页;《儿科学杂志》116卷(1990年)第38页;《儿科学杂志》134卷(1999年)第33页;《毒理学快报》102 - 103卷(1998年)第423页;《神经毒理学》21卷(6期)(2000年)第1029 - 1038页]。然而,由于并非所有研究都证实了这些关系(《儿科学杂志》119卷(1991年)第58 - 63页),关于产前接触多氯联苯在认知发展中的作用的争论仍在继续。本研究旨在提供更多数据以帮助解决这个问题。对参加奥斯威戈新生儿和婴儿发展项目的212名儿童在38个月大时使用麦卡锡儿童能力量表进行评估,随后在54个月大时进行重新评估。在首先控制了一系列认知发展的重要预测因素后,包括社会经济地位(SES)、母亲智商、母亲教育程度、家庭环境、吸烟情况以及许多其他因素,评估了产前接触多氯联苯(脐带血多氯联苯)与麦卡锡量表表现之间的关系。脐带血多氯联苯是38个月大时麦卡锡量表表现中虽小但可测量的缺陷的统计学显著预测因素。此外,发现脐带血多氯联苯与母亲头发汞含量(甲基汞)之间存在显著交互作用,即在产前多氯联苯接触水平较高的受试者中,产前甲基汞接触与麦卡锡量表表现之间存在负相关。在将近1.5年后(54个月大)对这些儿童进行重新评估时,未观察到多氯联苯和/或甲基汞与麦卡锡量表表现之间的关系。对麦卡锡量表表现的年龄相关轨迹检查发现,接触程度较高的儿童到54个月时赶上了接触程度最低的儿童。尽管当前数据部分重复了雅各布森等人、帕坦丁等人和瓦尔科维亚克等人的研究结果[《儿科学杂志》116卷(1990年)第38页;《儿科学杂志》134卷(1999年)第33页;《柳叶刀》358卷(2001年)第1602页],但此处报告的结果表明可能会发生功能恢复。此外,在后续研究中重复验证之前,多氯联苯与甲基汞之间的交互作用不能被视为定论。