Polanska Kinga, Krol Anna, Merecz-Kot Dorota, Ligocka Danuta, Mikolajewska Karolina, Mirabella Fiorino, Chiarotti Flavia, Calamandrei Gemma, Hanke Wojciech
Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
Department of Health and Work Psychology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
Int J Environ Res Public Health. 2017 Jul 17;14(7):796. doi: 10.3390/ijerph14070796.
The developing fetus is especially vulnerable to environmental toxicants, including tobacco constituents. The aim of this study was to assess the impact of environmental tobacco smoke (ETS) exposure during pregnancy on child neurodevelopment within the first two years of life. The study population consisted of 461 non-smoking pregnant women (saliva cotinine level <10 ng/mL). Maternal passive smoking was assessed based on the cotinine level in saliva analyzed by the use of high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS) and by questionnaire data. The cotinine cut-off value for passive smoking was established at 1.5 ng/mL (sensitivity 63%, specificity 71%). Psychomotor development was assessed in children at the age of one- and two-years using the Bayley Scales of Infant and Toddler Development. Approximately 30% of the women were exposed to ETS during pregnancy. The multivariate linear regression model indicated that ETS exposure in the 1st and the 2nd trimesters of pregnancy were associated with decreasing child language functions at the age of one (β = -3.0, = 0.03, and β = -4.1, = 0.008, respectively), and two years (β = -3.8, = 0.05, and β = -6.3, = 0.005, respectively). A negative association was found for cotinine level ≥1.5 ng/mL in the 2nd trimester of pregnancy and child cognition at the age of 2 (β = -4.6, = 0.05), as well as cotinine levels ≥1.5 ng/mL in all trimesters of pregnancy and child motor abilities at two years of age (β = -3.9, = 0.06, β = -5.3, = 0.02, and β = -4.2, = 0.05, for the 1st, the 2nd, and the 3rd trimester of pregnancy, respectively; for the 1st trimester the effect was of borderline statistical significance). This study confirmed that ETS exposure during pregnancy can have a negative impact on child psychomotor development within the first two years of life and underscore the importance of public health interventions aiming at reducing this exposure.
发育中的胎儿尤其容易受到包括烟草成分在内的环境毒物的影响。本研究的目的是评估孕期暴露于环境烟草烟雾（ETS）对儿童出生后两年内神经发育的影响。研究人群包括461名不吸烟的孕妇（唾液可替宁水平<10 ng/mL）。通过使用高效液相色谱串联质谱法（HPLC-ESI + MS/MS）分析唾液中的可替宁水平以及问卷调查数据来评估孕妇的被动吸烟情况。被动吸烟的可替宁临界值设定为1.5 ng/mL（灵敏度63%，特异性71%）。使用贝利婴幼儿发展量表在儿童1岁和2岁时评估其心理运动发育情况。约30%的女性在孕期暴露于ETS。多变量线性回归模型表明，孕期第1和第2孕期暴露于ETS与儿童1岁时语言功能下降有关（β分别为 -3.0，P = 0.03；β为 -4.1，P = 0.008），以及与2岁时语言功能下降有关（β分别为 -3.8，P = 0.05；β为 -6.3，P = 0.005）。发现孕期第2孕期可替宁水平≥1.5 ng/mL与儿童2岁时认知能力呈负相关（β = -4.6，P = 0.05），以及孕期所有孕期可替宁水平≥1.5 ng/mL与儿童2岁时运动能力呈负相关（孕期第1、第2和第3孕期的β分别为 -3.9，P = 0.06；β为 -5.3，P = 0.02；β为 -4.2，P = 0.05；第1孕期的影响具有边缘统计学意义）。本研究证实，孕期暴露于ETS会对儿童出生后两年内的心理运动发育产生负面影响，并强调了旨在减少这种暴露的公共卫生干预措施的重要性。
