Desrosiers Caroline, Boucher Olivier, Forget-Dubois Nadine, Dewailly Eric, Ayotte Pierre, Jacobson Sandra W, Jacobson Joseph L, Muckle Gina
Université Laval, Québec City, Québec, Canada; Centre de recherche du Centre Hospitalier Universitaire de Québec, Québec City, Québec, Canada.
Neurotoxicol Teratol. 2013 Sep-Oct;39:84-90. doi: 10.1016/j.ntt.2013.07.010. Epub 2013 Aug 2.
Smoking during pregnancy is common among Inuit women from the Canadian Arctic. Yet prenatal cigarette smoke exposure (PCSE) is seen as a major risk factor for childhood behavior problems. Recent data also suggest that co-exposure to neurotoxic environmental contaminants can exacerbate the effects of PCSE on behavior. This study examined the association between PCSE and behavior at school age in a sample of Inuit children from Nunavik, Québec, where co-exposure to environmental contaminants is also an important issue. Interactions with lead (Pb) and mercury (Hg), two contaminants associated with behavioral problems, were also explored.
Participants were 271 children (mean age=11.3years) involved in a prospective birth-cohort study. PCSE was assessed through maternal recall. Assessment of child behavior was obtained from the child's classroom teacher on the Teacher Report Form (TRF) and the Disruptive Behavior Disorders Rating Scale (DBD). Exposure to contaminants was assessed from umbilical cord and child blood samples. Other confounders were documented by maternal interview.
After control for contaminants and confounders, PCSE was associated with increased externalizing behaviors and attention problems on the TRF and higher prevalence of attention deficit hyperactivity disorder (ADHD) assessed on the DBD. No interactions were found with contaminants.
This study extends the existing empirical evidence linking PCSE to behavioral problems in school-aged children by reporting these effects in a population where tobacco use is normative rather than marginal. Co-exposure to Pb and Hg do not appear to exacerbate tobacco effects, suggesting that these substances act independently.
在加拿大北极地区的因纽特妇女中，孕期吸烟很常见。然而，产前接触香烟烟雾（PCSE）被视为儿童行为问题的主要风险因素。近期数据还表明，同时接触神经毒性环境污染物会加剧PCSE对行为的影响。本研究调查了魁北克努纳维克地区因纽特儿童样本中PCSE与学龄期行为之间的关联，该地区同时接触环境污染物也是一个重要问题。还探讨了与铅（Pb）和汞（Hg）这两种与行为问题相关的污染物的相互作用。
参与者为271名儿童（平均年龄 = 11.3岁），他们参与了一项前瞻性出生队列研究。通过母亲回忆评估PCSE。儿童行为评估来自儿童的课堂教师填写的教师报告表（TRF）和破坏性行为障碍评定量表（DBD）。通过脐带血和儿童血样评估污染物暴露情况。其他混杂因素通过母亲访谈记录。
在控制了污染物和混杂因素后，PCSE与TRF上外化行为增加和注意力问题以及DBD评估的注意力缺陷多动障碍（ADHD）患病率较高相关。未发现与污染物有相互作用。
本研究通过在吸烟为常态而非边缘现象的人群中报告这些影响，扩展了将PCSE与学龄儿童行为问题联系起来的现有实证证据。同时接触Pb和Hg似乎不会加剧烟草的影响，表明这些物质独立起作用。
