Goodman Michael, Squibb Katherine, Youngstrom Eric, Anthony Laura Gutermuth, Kenworthy Lauren, Lipkin Paul H, Mattison Donald R, Lakind Judy S
Department of Epidemiology, Emory University School of Public Health, Atlanta, Georgia, USA.
Environ Health Perspect. 2010 Jun;118(6):727-34. doi: 10.1289/ehp.0901835. Epub 2010 Feb 22.
Epidemiologic weight-of-evidence reviews to support regulatory decision making regarding the association between environmental chemical exposures and neurodevelopmental outcomes in children are often complicated by lack of consistency across studies.
We examined prospective cohort studies evaluating the relation between prenatal and neonatal exposure to polychlorinated biphenyls (PCBs) and neurodevelopment in children to assess the feasibility of conducting a meta-analysis to support decision making.
DATA EXTRACTION/SYNTHESIS: We described studies in terms of exposure and end point categorization, statistical analysis, and reporting of results. We used this evaluation to assess the feasibility of grouping studies into reasonably uniform categories.
The current literature includes 11 cohorts of children for whom effects from prenatal or neonatal PCB exposures were assessed. The most consistently used tests included Brazelton's Neonatal Behavioral Assessment Scale, the neurologic optimality score in the neonatal period, the Bayley Scales of Infant Development at 5-8 months of age, and the McCarthy Scales of Children's Abilities in 5-year-olds. Despite administering the same tests at similar ages, the studies were too dissimilar to allow a meaningful quantitative examination of outcomes across cohorts.
These analyses indicate that our ability to conduct weight-of-evidence assessments of the epidemiologic literature on neurotoxicants may be limited, even in the presence of multiple studies, if the available study methods, data analysis, and reporting lack comparability. Our findings add support to previous calls for establishing consensus standards for the conduct, analysis, and reporting of epidemiologic studies in general, and for those evaluating the effects of potential neurotoxic exposures in particular.
支持有关环境化学物质暴露与儿童神经发育结局之间关联的监管决策的流行病学证据权重综述，常常因各研究之间缺乏一致性而变得复杂。
我们考察了评估产前和新生儿期多氯联苯（PCBs）暴露与儿童神经发育之间关系的前瞻性队列研究，以评估进行荟萃分析以支持决策的可行性。
数据提取/综合：我们从暴露和终点分类、统计分析以及结果报告等方面描述了各项研究。我们利用这一评估来判断将研究分组为合理统一类别的可行性。
当前文献包含11个儿童队列，对其评估了产前或新生儿期PCB暴露的影响。最常用的测试包括布雷泽尔顿新生儿行为评估量表、新生儿期神经最优性评分、5至8个月大时的贝利婴儿发育量表以及5岁儿童的麦卡锡儿童能力量表。尽管在相似年龄进行了相同测试，但这些研究差异过大，无法对各队列的结局进行有意义的定量检验。
这些分析表明，如果现有研究方法、数据分析和报告缺乏可比性，那么即使有多项研究，我们对神经毒物流行病学文献进行证据权重评估的能力也可能有限。我们的研究结果支持了先前的呼吁，即总体上要为流行病学研究的开展、分析和报告建立共识标准，特别是针对那些评估潜在神经毒性暴露影响的研究。
