Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus (Tarragona), Catalonia, Spain; Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, PO Box 2060, 3000 CB, Rotterdam, the Netherlands.
Environ Pollut. 2021 Sep 1;284:117404. doi: 10.1016/j.envpol.2021.117404. Epub 2021 May 24.
Epidemiological studies mostly focus on single environmental exposures. This study aims to systematically assess associations between a wide range of prenatal and childhood environmental exposures and cognition. The study sample included data of 1298 mother-child pairs, children were 6-11 years-old, from six European birth cohorts. We measured 87 exposures during pregnancy and 122 cross-sectionally during childhood, including air pollution, built environment, meteorology, natural spaces, traffic, noise, chemicals and life styles. The measured cognitive domains were fluid intelligence (Raven's Coloured Progressive Matrices test, CPM), attention (Attention Network Test, ANT) and working memory (N-Back task). We used two statistical approaches to assess associations between exposure and child cognition: the exposome-wide association study (ExWAS) considering each exposure independently, and the deletion-substitution-addition algorithm (DSA) considering all exposures simultaneously to build a final multiexposure model. Based on this multiexposure model that included the exposure variables selected by ExWAS and DSA models, child organic food intake was associated with higher fluid intelligence (CPM) scores (beta = 1.18; 95% CI = 0.50, 1.87) and higher working memory (N-Back) scores (0.23; 0.05, 0.41), and child fast food intake (-1.25; -2.10, -0.40), house crowding (-0.39; -0.62, -0.16), and child environmental tobacco smoke (ETS) (-0.89; -1.42, -0.35), were all associated with lower CPM scores. Indoor PM exposure was associated with lower N-Back scores (-0.09; -0.16, -0.02). Additional associations in the unexpected direction were found: Higher prenatal mercury levels, maternal alcohol consumption and child higher perfluorooctane sulfonic acid (PFOS) levels were associated with better cognitive performance; and higher green exposure during pregnancy with lower cognitive performance. This first comprehensive and systematic study of many prenatal and childhood environmental risk factors suggests that unfavourable child nutrition, family crowdedness and child indoor air pollution and ETS exposures adversely and cross-sectionally associate with cognitive function. Unexpected associations were also observed and maybe due to confounding and reverse causality.
流行病学研究主要集中在单一的环境暴露上。本研究旨在系统评估广泛的产前和儿童期环境暴露与认知之间的关联。研究样本包括来自六个欧洲出生队列的 1298 对母婴数据，儿童年龄为 6-11 岁。我们在怀孕期间测量了 87 种暴露，在儿童期横截面上测量了 122 种暴露，包括空气污染、建筑环境、气象、自然空间、交通、噪音、化学物质和生活方式。测量的认知领域包括流体智力（瑞文彩色渐进矩阵测验，CPM）、注意力（注意网络测验，ANT）和工作记忆（N 回任务）。我们使用两种统计方法评估暴露与儿童认知之间的关联：考虑每个暴露因素的暴露组全关联研究（ExWAS），以及考虑所有暴露因素同时构建最终多暴露模型的删除-替换-添加算法（DSA）。基于包含 ExWAS 和 DSA 模型选择的暴露变量的多暴露模型，儿童有机食品摄入与更高的流体智力（CPM）得分（β=1.18；95%CI=0.50，1.87）和更高的工作记忆（N 回）得分（0.23；0.05，0.41）有关，而儿童快餐摄入（-1.25；-2.10，-0.40）、家庭拥挤（-0.39；-0.62，-0.16）和儿童环境烟草烟雾（ETS）（-0.89；-1.42，-0.35）均与 CPM 得分降低有关。室内 PM 暴露与 N 回得分降低有关（-0.09；-0.16，-0.02）。还发现了一些意想不到的关联：孕妇体内更高的汞水平、母亲饮酒和儿童体内更高的全氟辛烷磺酸（PFOS）水平与更好的认知表现有关；而怀孕期间更高的绿色暴露与更低的认知表现有关。这是首次对许多产前和儿童期环境风险因素进行全面系统的研究，表明不利的儿童营养、家庭拥挤和儿童室内空气污染以及 ETS 暴露与认知功能呈不利的横向关联。还观察到了一些意想不到的关联，这可能是由于混杂和反向因果关系。
