Santos Janelle, Pearce Sarah E, Stroustrup Annemarie
aIcahn School of Medicine at Mount Sinai bDepartment of Pediatrics, Division of Newborn Medicine cDepartment of Preventive Medicine, Ichan School of Medicine at Mount Sinai, New York, New York, USA.
Curr Opin Pediatr. 2015 Apr;27(2):254-60. doi: 10.1097/MOP.0000000000000190.
Over 300,000 infants are hospitalized in a neonatal intensive care unit (NICU) in the United States annually during a developmental period critical to later neurobehavioral function. Environmental exposures during the fetal period and infancy have been shown to impact long-term neurobehavioral outcomes. This review summarizes evidence linking NICU-based environmental exposures to neurodevelopmental outcomes of children born preterm.
Preterm infants experience multiple exposures important to neurodevelopment during the NICU hospitalization. The physical layout of the NICU, management of light and sound, social interactions with parents and NICU staff, and chemical exposures via medical equipment are important to long-term neurobehavioral outcomes in this highly vulnerable population.
Existing research documents NICU-based exposure to neurotoxic chemicals, aberrant light, excess sound, and restricted social interaction. In total, this creates an environment of co-existing excesses (chemicals, light, sound) and deprivation (touch, speech). The full impact of these co-exposures on the long-term neurodevelopment of preterm infants has not been adequately elucidated. Research into the importance of the NICU from an environmental health perspective is in its infancy, but could provide understanding about critical modifiable factors impacting the neurobehavioral health of hundreds of thousands of children each year.
在美国，每年有超过30万名婴儿在新生儿重症监护病房（NICU）住院，这一时期对其后期神经行为功能的发育至关重要。胎儿期和婴儿期的环境暴露已被证明会影响长期神经行为结局。本综述总结了将基于NICU的环境暴露与早产儿童神经发育结局相关联的证据。
早产婴儿在NICU住院期间会经历多种对神经发育重要的暴露。NICU的物理布局、光和声音的管理、与父母及NICU工作人员的社交互动以及通过医疗设备的化学暴露，对于这一高度脆弱人群的长期神经行为结局都很重要。
现有研究记录了在NICU接触神经毒性化学物质、异常光线、过度噪音以及社交互动受限的情况。总体而言，这营造了一个共存过度暴露（化学物质、光线、噪音）和剥夺（触摸、言语交流）的环境。这些共同暴露对早产婴儿长期神经发育的全面影响尚未得到充分阐明。从环境卫生角度对NICU重要性的研究尚处于起步阶段，但可能会为每年影响数十万儿童神经行为健康的关键可改变因素提供理解。
