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6 岁儿童暴露于产后早期霉菌污染房屋的认知功能。波兰前瞻性出生队列研究。

Cognitive function of 6-year old children exposed to mold-contaminated homes in early postnatal period. Prospective birth cohort study in Poland.

机构信息

Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Physiol Behav. 2011 Oct 24;104(5):989-95. doi: 10.1016/j.physbeh.2011.06.019. Epub 2011 Jul 8.

Abstract

In the last decade, the neurologic effects of various air pollutants have been the focus of increasing attention. The main purpose of this study was to assess the potential impact of early childhood exposure to indoor molds on the subsequent cognitive function of 6-year old children. The results of this study are based on the six-year follow-up of 277 babies born at term to mothers participating in a prospective cohort study in Krakow, Poland. The study participants are all non-smoking pregnant women who were free of chronic diseases such as diabetes and hypertension. The presence of visible mold patches on indoor walls was monitored at regular time intervals over gestation and after birth up to the age of five. The Wechsler Intelligence Scale for Children (WISC-R) was administered to children at age 6. The exposure effect of living in mold-contaminated homes on the IQ scores of children was adjusted for major confounders, known to be important for the cognitive development of children such as maternal education, the child's gender, breastfeeding practices in infancy, the presence of older siblings and the prenatal exposure to lead and environmental tobacco smoke (ETS). The adjusted IQ deficit attributed to longer exposures to indoor molds (>2 years) was significantly lower on the IQ scale (beta coeff.=-9.16, 95%CI: -15.21, -3.10) and tripled the risk of low IQ scoring (OR=3.53; 95%CI: 1.11-11.27) compared with references. While maternal education (beta coeff.=0.61, 95%CI: 0.05, 1.17) and breastfeeding (beta coeff.=4.0; 95%CI: 0.84, 7.17) showed a significant positive impact on cognitive function, prenatal ETS exposure (beta coeff.=-0.41; 95%CI: -0.79, -0.03) and the presence of older siblings (beta coefficient=-3.43; 95%CI: -5.67, -1.20) were associated with poorer cognitive function in children. In conclusion, the results of this study draw attention to the harmful effect of early postnatal exposure to indoor molds on children's cognitive development and provide additional evidence on the role of environmental determinants in human cognitive development.

摘要

在过去的十年中,各种空气污染物对神经系统的影响一直是人们关注的焦点。本研究的主要目的是评估儿童早期暴露于室内霉菌对 6 岁儿童随后认知功能的潜在影响。这项研究的结果基于 277 名足月出生的婴儿在波兰克拉科夫进行的前瞻性队列研究的六年随访。研究参与者均为不吸烟的孕妇,且没有糖尿病和高血压等慢性疾病。在妊娠期间和出生后直至 5 岁时,定期监测室内墙壁上可见的霉菌斑块。在 6 岁时,对儿童进行韦氏儿童智力量表(WISC-R)测试。将生活在受霉菌污染的家庭中的暴露效应调整为对儿童认知发育很重要的主要混杂因素,如母亲的教育程度、孩子的性别、婴儿期的母乳喂养习惯、是否有兄弟姐妹以及产前接触铅和环境烟草烟雾(ETS)。在 IQ 量表上,与较短时间暴露于室内霉菌(>2 年)相关的调整后 IQ 缺陷明显更低(β系数=-9.16,95%CI:-15.21,-3.10),并且将低 IQ 评分的风险增加了三倍(OR=3.53;95%CI:1.11-11.27)。而母亲的教育程度(β系数=0.61,95%CI:0.05,1.17)和母乳喂养(β系数=4.0;95%CI:0.84,7.17)对认知功能有显著的积极影响,而产前 ETS 暴露(β系数=-0.41;95%CI:-0.79,-0.03)和有兄弟姐妹(β系数=-3.43;95%CI:-5.67,-1.20)与儿童认知功能较差相关。总之,本研究结果提示我们,儿童早期暴露于室内霉菌对认知发育有不良影响,并为环境决定因素在人类认知发育中的作用提供了额外的证据。

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