孕期暴露于滴滴涕和拟除虫菊酯类杀虫剂以控制疟疾和儿童神经发育：南非 VHEMBE 队列研究。
Prenatal Exposure to DDT and Pyrethroids for Malaria Control and Child Neurodevelopment: The VHEMBE Cohort, South Africa.
机构信息
Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, California, USA.
University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
出版信息
Environ Health Perspect. 2018 Apr 6;126(4):047004. doi: 10.1289/EHP2129.
BACKGROUND
Although indoor residual spraying (IRS) with dichlorodiphenyltrichloroethane (DDT) and pyrethroids effectively controls malaria, it potentially increases human exposure to these insecticides. Previous studies suggest that prenatal exposure to these insecticides may impact human neurodevelopment.
OBJECTIVES
We aimed to estimate the effects of maternal insecticide exposure and neurodevelopment of toddlers living in a malaria-endemic region currently using IRS.
METHODS
The Venda Health Examination of Mothers, Babies and their Environment (VHEMBE) is a birth cohort of 752 mother-child pairs in Limpopo, South Africa. We measured maternal exposure to DDT and its breakdown product, dichlorodiphenyldichloroethylene (DDE), in maternal serum, and measured pyrethroid metabolites in maternal urine. We assessed children's neurodevelopment at 1 and 2 y of age using the Bayley Scales of Infant Development, third edition (BSID-III), and examined associations with maternal exposure.
RESULTS
DDT and DDE were not associated with significantly lower scores for any BSID-III scale. In contrast, each 10-fold increase in -DCCA, -DCCA, and 3-phenoxybenzoic acid were associated, respectively, with a -0.63 (95% CI: -1.14, -0.12), -0.48 (95% CI: -0.92, -0.05), and -0.58 (-1.11, -0.06) decrement in Social-Emotional scores at 1 y of age. In addition, each 10-fold increase in maternal -DBCA levels was associated with significant decrements at 2 y of age in Language Composite scores and Expressive Communication scores [β=-1.74 (95% CI: -3.34, -0.13) and β=-0.40 (95% CI: -0.77, -0.04), respectively, for a 10-fold increase]. Significant differences by sex were estimated for pyrethroid metabolites and motor function scores at 2 y of age, with higher scores for boys and lower scores for girls.
CONCLUSIONS
Prenatal exposure to pyrethroids may be associated at 1 y of age with poorer social-emotional development. At 2 y of age, poorer language development was observed with higher prenatal pyrethroid levels. Considering the widespread use of pyrethroids, these findings deserve further investigation. https://doi.org/10.1289/EHP2129.
背景
尽管室内滞留喷洒（IRS）使用滴滴涕（DDT）和拟除虫菊酯可有效控制疟疾，但它可能会增加人类接触这些杀虫剂的机会。先前的研究表明，产前接触这些杀虫剂可能会影响人类的神经发育。
目的
我们旨在评估在目前使用 IRS 的疟疾流行地区，母亲接触杀虫剂对幼儿神经发育的影响。
方法
文达母婴及其环境健康检查（VHEMBE）是南非林波波省的一个 752 对母婴队列研究。我们测量了母亲血清中 DDT 及其分解产物二氯二苯二氯乙烯（DDE）的暴露情况，并测量了母亲尿液中的拟除虫菊酯代谢物。我们使用贝利婴幼儿发展量表第三版（BSID-III）评估了儿童在 1 岁和 2 岁时的神经发育情况，并检查了与母亲暴露的相关性。
结果
DDT 和 DDE 与任何 BSID-III 量表的评分均无显著相关性。相反，-DCCA、-DCCA 和 3-苯氧基苯甲酸每增加 10 倍，分别与 1 岁时社会情感评分降低 0.63（95%CI：-1.14，-0.12）、0.48（95%CI：-0.92，-0.05）和 0.58（-1.11，-0.06）有关。此外，母亲-DBCA 水平每增加 10 倍，2 岁时语言综合评分和表达性沟通评分显著降低[β=-1.74（95%CI：-3.34，-0.13）和β=-0.40（95%CI：-0.77，-0.04），分别为 10 倍增加]。对于 2 岁时的运动功能评分，我们还估计了性别之间的差异，男孩的评分较高，女孩的评分较低。
结论
产前接触拟除虫菊酯可能与 1 岁时较差的社会情感发展有关。在 2 岁时，较高的产前拟除虫菊酯水平与较差的语言发展有关。考虑到拟除虫菊酯的广泛使用，这些发现值得进一步研究。https://doi.org/10.1289/EHP2129.
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