Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
Sci Total Environ. 2017 Dec 31;607-608:475-482. doi: 10.1016/j.scitotenv.2017.06.168. Epub 2017 Jul 27.
Among a cohort of children located in rural areas of Bangladesh affected by high levels of exposure to environmental metals, we investigated the associations between anthropometric measures, growth trajectory, and neurodevelopment at age 20-40months. Our study population included mothers and their children who participated in a longitudinal birth cohort study that took in place in the Pabna and Sirajdikhan areas of Bangladesh. Anthropometric measures including weight, length, and head circumference were measured at birth, age 12months, and age 20-40months. Neurodevelopment was assessed using Bayley Scales of Infant and Toddler Development Third Edition (BSID-III) multi-scale at age 20-40months. A total of 777 mother-child pairs were included. Higher anthropometric measures at 20-40months were associated with higher cognitive, language, and motor scores on BSID-III. For example, a 1-kg increment in birthweight was associated with an increase of 2.11 for cognitive score (p<0.0001), 1.63 for language score (p=0.006), and 0.89 for motor scores (p=0.03). Greater positive changes in growth parameters, or growth trajectory, between birth and 20-40months were also associated with higher BSID-III scores. These associations remained significant after adjusting for potential confounders and prenatal exposure to environmental metals. These findings suggest that even when taking into account high environmental metal exposures, prenatal and early childhood growth have strong associations with neurodevelopmental test scores in early childhood.
在孟加拉国农村地区的一个儿童队列中，这些儿童受到高水平环境金属暴露的影响，我们调查了在 20-40 个月龄时，人体测量学指标、生长轨迹和神经发育之间的关系。我们的研究人群包括参加孟加拉国巴纳和锡拉杰甘地区纵向出生队列研究的母亲及其子女。在出生时、12 个月龄和 20-40 个月龄时测量了体重、长度和头围等人体测量学指标。在 20-40 个月龄时使用贝利婴幼儿发育量表第三版（BSID-III）多尺度评估了神经发育情况。共有 777 对母婴对。20-40 个月时较高的人体测量指标与 BSID-III 的认知、语言和运动评分较高有关。例如，出生体重增加 1 公斤，认知评分增加 2.11（p<0.0001），语言评分增加 1.63（p=0.006），运动评分增加 0.89（p=0.03）。出生至 20-40 个月期间生长参数（或生长轨迹）的较大正变化也与较高的 BSID-III 评分相关。在调整了潜在混杂因素和环境金属的产前暴露后，这些关联仍然显著。这些发现表明，即使考虑到高环境金属暴露，产前和儿童早期的生长与儿童早期的神经发育测试评分有很强的关联。
