孕期邻苯二甲酸酯混合物与自闭症特征和儿童期不良行为结局的关系
Phthalate mixtures in pregnancy, autistic traits, and adverse childhood behavioral outcomes.
机构信息
Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA.
Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA.
出版信息
Environ Int. 2021 Feb;147:106330. doi: 10.1016/j.envint.2020.106330. Epub 2021 Jan 5.
BACKGROUND
Prenatal exposure to multiple phthalates is ubiquitous, and yet few studies have evaluated these exposures as a mixture in relation to child autistic traits and behavioral problems.
OBJECTIVES
To assess cumulative associations between prenatal phthalate mixtures and child behaviors, including effect modification by exposure timing and child sex.
METHODS
Analyses included 501 mother/child pairs from the multicenter pregnancy cohort The Infant Development and Environment Study (TIDES). Nine maternal urinary phthalate metabolites were measured in early and late pregnancy, and behavior was assessed at ages 4-5 years using composite T scores for the Behavioral Assessment System for Children (BASC-2), which measures several dimensions of child behavior, and the Social Responsiveness Scale (SRS-2), which measures social impairment consistent with autistic traits. We utilized weighted quantile sum (WQS) regressions to examine pregnancy period-specific associations between phthalate mixtures and behavioral outcomes. Full-sample 95% WQS confidence intervals are known to be anti-conservative, so we calculated a confirmatory p-value using a permutation test. Effect modification by sex was examined with stratified analyses.
RESULTS
A one-quintile increase in the early pregnancy phthalate mixture was associated with increased SRS-2 total score (coefficient = 1.0, confirmatory p = 0.01) and worse adaptive skills (coefficient = -1.0, confirmatory p = 0.06) in both sexes. In sex-stratified analyses, the early pregnancy phthalate mixture was associated with increased SRS-2 total score in boys (coefficient = 1.2, confirmatory p = 0.04) and girls (coefficient = 1.0, confirmatory p = 0.10) and worse BASC-2 adaptive skills score in girls (coefficient = -1.5, confirmatory p = 0.06), while the late pregnancy phthalate mixture was associated with increased BASC-2 externalizing score in boys (coefficient = 1.3, confirmatory p = 0.03).
CONCLUSION
Our results suggest cumulative adverse associations between prenatal phthalate mixtures and multiple facets of childhood behavior.
背景
产前接触多种邻苯二甲酸酯是普遍存在的，但很少有研究评估这些暴露作为混合物与儿童自闭症特征和行为问题的关系。
目的
评估产前邻苯二甲酸酯混合物与儿童行为之间的累积关联，包括暴露时间和儿童性别对其的效应修饰作用。
方法
本研究分析了多中心妊娠队列婴儿发育与环境研究（TIDES）中的 501 对母婴。在妊娠早期和晚期测量了 9 种母体尿液邻苯二甲酸酯代谢物，在 4-5 岁时使用儿童行为评估系统（BASC-2）的复合 T 评分和社会反应量表（SRS-2）评估行为，BASC-2 测量儿童行为的多个维度，SRS-2 则测量符合自闭症特征的社会障碍。我们利用加权分位数总和（WQS）回归来研究妊娠期间特定阶段邻苯二甲酸酯混合物与行为结果之间的关系。全样本 95%WQS 置信区间已知为反保守，因此我们使用置换检验计算了确认性 p 值。通过分层分析检验性别对效应的修饰作用。
结果
妊娠早期邻苯二甲酸酯混合物增加一个五分位，与男孩和女孩的 SRS-2 总分增加（男孩：系数=1.2，确认性 p=0.04；女孩：系数=1.0，确认性 p=0.10）和女孩的 BASC-2 适应技能评分降低（系数=-1.5，确认性 p=0.06）相关，而妊娠晚期邻苯二甲酸酯混合物与男孩的 BASC-2 外显化评分增加（系数=1.3，确认性 p=0.03）相关。
结论
我们的研究结果表明，产前邻苯二甲酸酯混合物与儿童行为的多个方面存在累积的不良关联。
Zotero 插件