Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA.
Department of Health Security, Finnish Institute for Health and Welfare (THL), Kuopio, Finland.
Environ Res. 2022 Sep;212(Pt A):113145. doi: 10.1016/j.envres.2022.113145. Epub 2022 Mar 19.
Evidence implicates environmental factors in attention-deficit/hyperactivity disorder (ADHD) risk. Prenatal exposures to polychlorinated biphenyls (PCBs) and the pesticide metabolite p,p'-dichlorodiphenyl dichloroethylene (DDE) have been linked to lower cognitive ability, increased impulsivity, and attention related deficits in the offspring. However, information on the relationship of these exposures to the risk of clinically diagnosed ADHD is limited.
To determine whether prenatal maternal levels of PCBs or DDE are associated with ADHD diagnosis in the offspring.
The investigation was conducted in the Finnish Prenatal Study of ADHD (FIPS-ADHD), a case-control study nested in a national birth cohort. Cases were born in 1998 or 1999 and diagnosed with ADHD (ICD-9 314x or ICD-10 F90. x) according to the national Care Register for Health Care. Each case was individually matched to a control on sex, date, and place of birth. PCB congeners (PCB 74, 99, 118, 138, 153, 156, 170, 180, 183, 187) and DDE were quantified from archived prenatal maternal sera from 359 matched case-control pairs using gas chromatography - high triple quadrupole mass spectrometry. Maternal total PCBs were quantified as the sum of concentrations of the measured congeners. Associations with ADHD were examined using conditional logistic regression.
Maternal PCB or DDE levels greater than the 75th percentiles of the control distributions showed no evidence of association with offspring ADHD (PCBs: adjusted odds ratio (aOR) = 1.01, 95% CI = 0.63, 1.60), p = 0.98; DDE: aOR = 1.13, 95% CI = 0.71, 1.81; p = 0.60). Maternal levels of either pollutant dichotomized at the 90th percentile or considered as a continuous variable also did not show evidence for association with offspring ADHD diagnosis.
This study did not find evidence for association of maternal prenatal levels of PCBs or DDE with clinical diagnosis of offspring ADHD; however, this does not rule out the possibility of an impact on subclinical phenotypes.
有证据表明环境因素与注意力缺陷多动障碍（ADHD）风险有关。多氯联苯（PCBs）和杀虫剂代谢物 p,p'-二氯二苯二氯乙烯（DDE）的产前暴露与后代认知能力下降、冲动性增加和注意力相关缺陷有关。然而，关于这些暴露与临床诊断为 ADHD 的风险之间的关系的信息有限。
确定母体产前 PCBs 或 DDE 水平是否与后代的 ADHD 诊断有关。
该研究在芬兰 ADHD 产前研究（FIPS-ADHD）中进行，这是一项嵌套在全国出生队列中的病例对照研究。病例出生于 1998 年或 1999 年，并根据国家保健登记处按照 ICD-9（314x）或 ICD-10（F90.x）诊断为 ADHD。每个病例与性别、日期和出生地相匹配的对照进行单独匹配。使用气相色谱-高三重四极杆质谱法从 359 对匹配的病例对照中分析存档的产前母体血清中的 PCB 同系物（PCB 74、99、118、138、153、156、170、180、183、187）和 DDE。母体总 PCBs 的含量通过测量同系物的浓度之和来定量。使用条件逻辑回归检查与 ADHD 的关联。
母体 PCBs 或 DDE 水平超过对照组分布的第 75 个百分位数与后代 ADHD 没有关联的证据（PCBs：调整后的优势比（aOR）= 1.01，95%CI= 0.63，1.60），p=0.98；DDE：aOR=1.13，95%CI=0.71，1.81；p=0.60）。将污染物的母体水平在第 90 个百分位数处二值化或视为连续变量，也没有证据表明与后代 ADHD 诊断有关。
本研究没有发现母体产前 PCBs 或 DDE 水平与后代 ADHD 临床诊断有关的证据；然而，这并不能排除对亚临床表型产生影响的可能性。
