孕期尿液邻苯二甲酸代谢物水平与儿童 2 至 3 岁时的神经发育。
Prenatal urinary phthalate metabolites levels and neurodevelopment in children at two and three years of age.
机构信息
Division of Statistics, Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
出版信息
Sci Total Environ. 2013 Sep 1;461-462:386-90. doi: 10.1016/j.scitotenv.2013.05.021. Epub 2013 Jun 5.
BACKGROUND
Previous studies suggest that prenatal phthalate exposure affects neurodevelopment and behavior during the first years of life.
OBJECTIVES
To evaluate the effect of maternal urinary concentrations of phthalate metabolites during pregnancy on mental and psychomotor development in children 24-36 months of age.
METHODS
This analysis was conducted on the first three years of life among a subsample of 136 mother-child pairs from the ELEMENT cohort studies conducted in Mexico City. Maternal urine samples collected during the third trimester of pregnancy were analyzed for 9 phthalate metabolites: Mono-ethyl phthalate (MEP), Mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP), Mono-3-carboxypropyl phthalate (MCPP), and four di-2-ethylhexyl phthalate (DEHP) metabolites [mono-2-ethylhexyl-phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP)]. Among the 136 children, 135 (99.3%) completed the study period. Child neurodevelopment was assessed using mental and psychomotor development indexes (MDI and PDI) from a Bayley (BSID II) test at 24, 30, and 36 months of age. The effect of prenatal phthalate exposure on neurodevelopment was estimated using linear regression models for longitudinal data clustered at the individual level.
RESULTS
No significant associations were observed among all children combined, but differential effects by gender were found. Among girls, there was a negative association between MDI and DEHP metabolites MEHP (β=-2.11 [95% CI: -3.73, -0.49]), MEHHP (β=-1.89 [95% CI: -3.64, -0.15]), MEOHP (β=-1.80 [95% CI: -3.58, -0.03]) MECPP (β=-2.52 [95% CI: -4.44, -0.61]), and ΣDEHP (β=-3.41 [95% CI: -5.26, -1.55]); there was no significant effect among boys. Male PDI was positively related to MBzP (β=1.79 [95% CI: 0.14, 3.45]) and MCPP (β=1.64 [95% CI: 0.15, 3.12]); there was no significant effect on PDI among girls.
CONCLUSION
This study demonstrates that sex plays a role of an effect modifier in the association between prenatal phthalate exposure and neurodevelopment.
背景
先前的研究表明，产前邻苯二甲酸酯暴露会影响儿童生命最初几年的神经发育和行为。
目的
评估孕妇妊娠期间尿液中邻苯二甲酸酯代谢物浓度对 24-36 个月儿童精神和运动发育的影响。
方法
这是在墨西哥城进行的 ELEMENT 队列研究的前三年中对 136 对母婴对子的一个亚组进行的分析。在妊娠晚期收集的孕妇尿液样本用于分析 9 种邻苯二甲酸酯代谢物：单乙基邻苯二甲酸酯（MEP）、单正丁基邻苯二甲酸酯（MnBP）、单异丁基邻苯二甲酸酯（MiBP）、单苄基邻苯二甲酸酯（MBzP）、单-3-羧基丙基邻苯二甲酸酯（MCPP）和四种邻苯二甲酸二（2-乙基己基）酯（DEHP）代谢物[单-2-乙基己基邻苯二甲酸酯（MEHP）、单-（2-乙基-5-羟基己基）邻苯二甲酸酯（MEHHP）、单-（2-乙基-5-氧代己基）邻苯二甲酸酯（MEOHP）和单-（2-乙基-5-羧基戊基）邻苯二甲酸酯（MECPP）]。在 136 名儿童中，有 135 名（99.3%）完成了研究期。使用贝利（BSID II）测试在 24、30 和 36 个月时评估儿童神经发育的精神和运动发育指数（MDI 和 PDI）。使用个体水平聚类的纵向数据线性回归模型估计产前邻苯二甲酸酯暴露对神经发育的影响。
结果
在所有儿童中均未观察到显著关联，但发现了性别差异的影响。在女孩中，MDI 与 DEHP 代谢物 MEHP（β=-2.11[95%CI：-3.73，-0.49]）、MEHHP（β=-1.89[95%CI：-3.64，-0.15]）、MEOHP（β=-1.80[95%CI：-3.58，-0.03]）、MECPP（β=-2.52[95%CI：-4.44，-0.61]）和ΣDEHP（β=-3.41[95%CI：-5.26，-1.55]）之间呈负相关；在男孩中没有显著影响。男孩的 PDI 与 MBzP（β=1.79[95%CI：0.14，3.45]）和 MCPP（β=1.64[95%CI：0.15，3.12]）呈正相关；在女孩中对 PDI 没有显著影响。
结论
这项研究表明，性别在产前邻苯二甲酸酯暴露与神经发育之间的关联中起作用修饰剂的作用。
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