Centre for Behavioral Sciences and Mental Health, National Institute of Health (ISS), Rome, Italy.
Centre for Behavioral Sciences and Mental Health, National Institute of Health (ISS), Rome, Italy.
Environ Res. 2020 Feb;181:108856. doi: 10.1016/j.envres.2019.108856. Epub 2019 Oct 25.
Characterization of the exposome, the totality of all environmental factors that one is exposed to from conception onwards, has been recommended to better evaluate the role of environmental influences on developmental programming and life-course vulnerability to major chronic diseases. In the framework of the Health and Environment-wide Associations based on Large population Surveys (HEALS) project we considered the pregnancy exposome exploiting two databases (PHIME and REPRO_PL) that include birth cohorts from three EU countries (Croatia, Slovenia and Poland). The databases contained information on several chemical exposures, socio-demographic, lifestyle and health related factors from conception to child birth, and neuropsychological scores assessed by the Bayley Scales of Infant and Toddler Development in the first two years of life. Our main goal was to assess consistency of environmental influences on neurodevelopment, if any, across European countries differing for geographical, socio-demographic characteristics and levels of chemical exposures to metals such as lead (Pb), mercury (Hg), cadmium (Cd) and trace elements, including micronutrients such as zinc (Zn) and selenium (Se). To this aim, we first selected variables common to the different databases, then applied univariate and multivariate regression analyses to identify factors linked to neurodevelopment, and finally performed meta-analysis to detect potential heterogeneity among cohorts and pooled estimates. Significant differences in exposure levels among the three sub-cohorts were observed as for Hg and Se; exposure levels under study were relatively low and within the range described in existing EU biomonitoring studies. The univariate analyses did not show any common pattern of association as only in the Polish cohort chemical exposure had an impact on neuropsychological outcome. In the meta-analysis, some consistent trends were evident, relative to the adverse influence of Pb on children's language and cognition and the positive influence of Se on language abilities. The effects of the neurotoxic metal Hg positively influenced the motor scores in the Polish cohorts, while it decreased the motor scores in the Slovenia and Croatian sub-cohorts. The only socio-demographic factor consistently associated to the outcome among cohorts was child's sex, with females performing better than males on cognitive and language scores. These findings point to the need of harmonizing existing cohorts or creating prospective study designs that facilitate comparisons in the exposome over time, places and kind of environmental exposures.
对个体从受孕到出生后所接触到的全部环境因素（外核组）进行特征描述，这一做法已被推荐用于更好地评估环境因素对发育编程和生命过程中发生重大慢性疾病的易感性的影响。在健康与环境关联的大型人群调查（HEALS）项目框架内，我们利用两个包含来自三个欧盟国家（克罗地亚、斯洛文尼亚和波兰）的出生队列的数据库（PHIME 和 REPRO_PL）来研究妊娠外核组。这些数据库包含了受孕至分娩期间的多项化学暴露、社会人口统计学、生活方式和健康相关因素，以及在生命的头两年通过贝利婴幼儿发育量表评估的神经心理学评分。我们的主要目标是评估如果存在的话，在地理、社会人口统计学特征以及金属（如铅、汞、镉）和痕量元素（包括锌和硒等微量元素）等化学暴露水平存在差异的欧洲国家中，环境因素对神经发育的影响是否具有一致性。为此，我们首先选择了不同数据库中共同的变量，然后应用单变量和多变量回归分析来确定与神经发育相关的因素，最后进行荟萃分析以检测队列之间的潜在异质性和汇总估计值。观察到三个亚队列之间的 Hg 和 Se 暴露水平存在显著差异；研究中暴露水平相对较低，处于现有欧盟生物监测研究描述的范围内。单变量分析没有显示出任何共同的关联模式，因为只有在波兰队列中，化学暴露对神经心理学结果有影响。在荟萃分析中，一些一致的趋势是明显的，与 Pb 对儿童语言和认知的不良影响以及 Se 对语言能力的积极影响有关。神经毒性金属 Hg 的影响在波兰队列中对运动评分有积极影响，而在斯洛文尼亚和克罗地亚亚队列中则降低了运动评分。在队列中与结果始终相关的唯一社会人口统计学因素是儿童的性别，女性在认知和语言评分上优于男性。这些发现表明需要协调现有的队列或创建前瞻性研究设计，以促进在时间、地点和环境暴露类型方面对外核组的比较。
