Department of Paediatrics, University Hospital Centre, Istarska 43, 51000, Rijeka, Croatia.
Department of Paediatrics, University Hospital Centre, Istarska 43, 51000, Rijeka, Croatia.
Environ Res. 2019 Nov;178:108682. doi: 10.1016/j.envres.2019.108682. Epub 2019 Aug 20.
Prenatal exposure of long chain polyunsaturated fatty acids (LCPUFA) are essential for normal fetal growth and neurodevelopment. Availability of LCPUFA depends mostly on maternal fish consumption. Fish consumption also exposes the fetus to mercury which is well known neurotoxicant. We analyzed the associations of combined LCPUFA and mercury from fish consumption during pregnancy on newborn's brain measures and child neurodevelopment in a northern Adriatic coastal area.
The prospective cohort study included 257 mother - infant pairs enrolled in a susceptible population of the Public Health Impact on long-term, low-level, Mixed Element exposure (PHIME) EU Sixth Framework Programme from 2 recruitment areas of the northern part of the Adriatic coast. Umbilical cord blood taken at delivery was used for measuring concentration of total mercury (THg) and specific LCPUFA - docosahexaenoic acid (DHA) and arachidonic acid (ARA). Neonatal cranial sonography was performed at the age of 3 days in 57 newborns. Neurodevelopmental assessment of cognitive, motor and language skills were conducted at 257 children at the age of 18 months using the Bayley Scales of Infant and Toddler Development, Third Edition. The participants were divided into two groups depending on the THg concentration in the umbilical cord blood (exposed > 5.8 μg/L and unexposed < 5.8 μg/L). Dietary habits and exposures to environmental and social factors were assessed through questionnaires.
There is a statistically significant difference in the cerebellum length (p = 0.032) and the superior frontal gyrus width (p = 0.023) between the exposed and the unexposed group. In combined analysis, including possible protective variables as DHA and ARA (R = 0.22, p = 0.001), the negative contribution of THg on cerebellum length (beta = -0.16, p = 0.001) persisted. We found no correlation between THg concentration in umbilical cord blood and child neurodevelopment scores at the age of 18 months. Language score with receptive and expressive subscores was significantly associated with fish consumption (p < 0.05).
This analysis demonstrates the existence of morphological brain changes in newborns that are prenatally exposed at mercury concentrations what was diminished in combined analyse including LCPUFA. Our results emphasizes the importance of LCPUFA's and mercury common influence as a predictor of developmental outcome. Fish consumption, not solely LCPUFA contributes to better language development of children at the age of 18 months.
长链多不饱和脂肪酸（LCPUFA）的产前暴露对胎儿的正常生长和神经发育至关重要。LCPUFA 的供应主要取决于母亲食用鱼类的情况。食用鱼类还会使胎儿接触到汞，汞是一种众所周知的神经毒素。我们分析了怀孕期间食用鱼类的 LCPUFA 和汞的联合暴露对亚得里亚海北部沿海地区新生儿大脑测量和儿童神经发育的影响。
这项前瞻性队列研究纳入了 257 对母婴对，他们来自欧盟第六框架计划公共卫生对长期、低水平、混合元素暴露（PHIME）项目的两个北方亚得里亚海沿岸的招募地区，属于易感人群。分娩时采集脐带血，用于测量总汞（THg）和特定 LCPUFA-二十二碳六烯酸（DHA）和花生四烯酸（ARA）的浓度。在 57 名新生儿出生后 3 天进行新生儿颅超声检查。在 18 个月时，使用贝利婴幼儿发育量表第三版对 257 名儿童的认知、运动和语言技能进行神经发育评估。根据脐带血中 THg 浓度（暴露组>5.8μg/L，未暴露组<5.8μg/L）将参与者分为两组。通过问卷调查评估饮食和环境及社会因素暴露情况。
在小脑长度（p=0.032）和额上回宽度（p=0.023）方面，暴露组与未暴露组之间存在统计学差异。在包括 DHA 和 ARA 等可能的保护变量的综合分析中（R=0.22，p=0.001），THg 对小脑长度的负贡献（β=-0.16，p=0.001）仍然存在。我们没有发现脐带血中 THg 浓度与 18 个月时儿童神经发育评分之间的相关性。语言评分与接受性和表达性子评分显著相关（p<0.05）。
本分析表明，在新生儿中存在形态学脑改变，这些改变是在汞浓度下发生的，而在包括 LCPUFA 的综合分析中，这种改变则有所减少。我们的研究结果强调了 LCPUFA 和汞共同影响作为发育结果预测因子的重要性。鱼类的食用，而不仅仅是 LCPUFA，有助于 18 个月儿童的语言发展。
