Spanier Adam J, Kahn Robert S, Kunselman Allen R, Schaefer Eric W, Hornung Richard, Xu Yingying, Calafat Antonia M, Lanphear Bruce P
Department of Pediatrics, Penn State University Hershey Medical Center, Hershey, Pennsylvania2Department of Public Health Sciences, Penn State University Hershey Medical Center, Hershey, Pennsylvania3currently with the Department of Pediatrics, University.
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
JAMA Pediatr. 2014 Dec;168(12):1131-7. doi: 10.1001/jamapediatrics.2014.1397.
Bisphenol A (BPA), a prevalent endocrine-disrupting chemical, has been associated with wheezing in children, but few studies have examined its effect on lung function or wheeze in older children.
To test whether BPA exposure is associated with lung function, with wheeze, and with pattern of wheeze in children during their first 5 years.
DESIGN, SETTING, AND PARTICIPANTS: A birth cohort study, enrolled during early pregnancy in the greater Cincinnati, Ohio, area among 398 mother-infant dyads. We collected maternal urine samples during pregnancy (at 16 and 26 weeks) and child urine samples annually to assess gestational and child BPA exposure.
We assessed parent-reported wheeze every 6 months for 5 years and measured child forced expiratory volume in the first second of expiration (FEV1) at age 4 and 5 years. We evaluated associations of BPA exposure with respiratory outcomes, including FEV1, child wheeze, and wheeze phenotype.
Urinary BPA concentrations and FEV1 data were available for 208 children and urinary BPA concentrations and parent-reported wheeze data were available for 360 children. The mean maternal urinary BPA concentration ranged from 0.53 to 293.55 µg/g of creatinine. In multivariable analysis, every 10-fold increase in the mean maternal urinary BPA concentration was associated with a 14.2% (95% CI, -24.5% to -3.9%) decrease in the percentage predicted FEV1 at 4 years, but no association was found at 5 years. In multivariable analysis, every 10-fold increase in the mean maternal urinary BPA concentration was marginally associated with a 54.8% increase in the odds of wheezing (adjusted odds ratio, 1.55; 95% CI, 0.91-2.63). While the mean maternal urinary BPA concentration was not associated with wheeze phenotype, a 10-fold increase in the 16-week maternal urinary BPA concentration was associated with a 4.27-fold increase in the odds of persistent wheeze (adjusted odds ratio, 4.27; 95% CI, 1.37-13.30). Child urinary BPA concentrations were not associated with FEV1 or wheeze.
These results provide evidence suggesting that prenatal but not postnatal exposure to BPA is associated with diminished lung function and the development of persistent wheeze in children.
双酚A（BPA）是一种普遍存在的内分泌干扰化学物质，与儿童喘息有关，但很少有研究考察其对大龄儿童肺功能或喘息的影响。
检验双酚A暴露是否与儿童5岁前的肺功能、喘息及喘息模式有关。
设计、地点和参与者：一项出生队列研究，在俄亥俄州大辛辛那提地区的早孕期招募了398对母婴。我们在孕期（16周和26周时）收集母亲尿液样本，并每年收集儿童尿液样本，以评估孕期和儿童期的双酚A暴露情况。
我们在5年中每6个月评估一次家长报告的喘息情况，并在4岁和5岁时测量儿童第一秒用力呼气量（FEV1）。我们评估了双酚A暴露与呼吸结局的关联，包括FEV1、儿童喘息和喘息表型。
208名儿童有尿液双酚A浓度和FEV1数据，360名儿童有尿液双酚A浓度和家长报告的喘息数据。母亲尿液中双酚A的平均浓度范围为0.53至293.55μg/g肌酐。在多变量分析中，母亲尿液中双酚A平均浓度每增加10倍，与4岁时预测FEV1百分比降低14.2%（95%CI，-24.5%至-3.9%）相关，但在5岁时未发现关联。在多变量分析中，母亲尿液中双酚A平均浓度每增加10倍，与喘息几率增加54.8%（调整后的优势比，1.55；95%CI，0.91-2.63）有微弱关联。虽然母亲尿液中双酚A平均浓度与喘息表型无关，但母亲16周时尿液中双酚A浓度增加10倍，与持续性喘息几率增加4.27倍（调整后的优势比，4.27；95%CI，1.37-13.30）相关。儿童尿液中双酚A浓度与FEV1或喘息无关。
这些结果提供了证据，表明产前而非产后暴露于双酚A与儿童肺功能下降和持续性喘息的发生有关。
