Gascon Mireia, Guxens Mònica, Vrijheid Martine, Torrent Maties, Ibarluzea Jesús, Fano Eduardo, Llop Sabrina, Ballester Ferran, Fernández Mariana F, Tardón Adonina, Fernández-Somoano Ana, Sunyer Jordi
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.
Int J Hyg Environ Health. 2017 Jun;220(4):647-658. doi: 10.1016/j.ijheh.2017.02.008. Epub 2017 Feb 28.
In 2003 the INMA-INfancia y Medio Ambiente (Environment and Childhood) project, a Spanish national network of birth cohorts including more than 3500 participants, was set up with the aim to assess the health impacts of pre- and postnatal environmental exposures on children. The project has published more than 60 papers on maternal and environmental factors related to neuropsychological development in children, one of the main research interests within the project. With the present review, we evaluate the evidence provided by the INMA project on this topic and discuss how the data can contribute to cover the challenges that children's environmental health research will face in the coming years.
The INMA project has contributed to provide increasing evidence of the association between prenatal exposure to persistent organic pollutants (POPs) and child neuropsychological development, but it has also shown, using innovative methodologies, that postnatal exposure to these compounds does not play a role in this association. The project has also contributed to show the detrimental influence of certain air pollutants on child neuropsychological development, as well as how a balanced maternal fish intake can protect from the potential adverse effects of prenatal exposure to mercury. Also, the project has contributed to the understanding of impacts of nutritional factors including supplement intake and vitamin D levels during pregnancy and the role of breastfeeding on the neuropsychological benefits.
INMA findings underscore the importance of continued research on the delineation of the sensitive windows of exposure both during pregnancy and postnatally and on the combined effects of environmental exposures, denoted the exposome. In terms of health policy, INMA findings have important implications for the development of public health policies to advance the health and development of children.
2003年，西班牙国家出生队列网络“环境与儿童健康研究项目（INMA-INfancia y Medio Ambiente）”成立，该项目有超过3500名参与者，旨在评估产前和产后环境暴露对儿童健康的影响。该项目已发表60多篇关于儿童神经心理发展相关的母体和环境因素的论文，这是该项目的主要研究兴趣之一。通过本综述，我们评估了INMA项目在这一主题上提供的证据，并讨论了这些数据如何有助于应对儿童环境卫生研究在未来几年将面临的挑战。
INMA项目为产前接触持久性有机污染物（POPs）与儿童神经心理发展之间的关联提供了越来越多的证据，但它也使用创新方法表明，产后接触这些化合物在这种关联中不起作用。该项目还有助于表明某些空气污染物对儿童神经心理发展的有害影响，以及母亲均衡摄入鱼类如何能够预防产前接触汞的潜在不利影响。此外，该项目有助于理解营养因素的影响，包括孕期补充剂摄入和维生素D水平，以及母乳喂养对神经心理益处的作用。
INMA的研究结果强调了持续研究孕期和产后暴露敏感窗口期以及环境暴露综合影响（即暴露组）的重要性。在卫生政策方面，INMA的研究结果对制定促进儿童健康和发展的公共卫生政策具有重要意义。
