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母体暴露于农药与后代自闭症或注意缺陷多动障碍的关系:一项荟萃分析。

Maternal exposure to pesticides and autism or attention-deficit/hyperactivity disorders in offspring: A meta-analysis.

机构信息

State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.

Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.

出版信息

Chemosphere. 2023 Feb;313:137459. doi: 10.1016/j.chemosphere.2022.137459. Epub 2022 Dec 2.

Abstract

OBJECTIVE

To analyze the association between maternal pesticide exposure and autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorders (ADHD) in offspring.

METHOD

Five databases including PubMed, Embase, Web of Science, Medline, as well as PsycINFO were systematically retrieved for the records related to pesticide exposure during pregnancy and ASD and ADHD in offspring before August 30, 2022. The pesticide category, maternal age and window of exposure as the main subgroups were presented.

RESULTS

949 studies were initially identified, and 19 studies were eventually included. Eleven were on ASD, seven were on ADHD, and one was on both disorders. Maternal pesticide exposure was positively related to ASD (pooled OR = 1.19 (95%CI: 1.04 to 1.36)) and ADHD (pooled OR = 1.20 (95%CI: 1.04 to 1.38)) in offspring. In the subgroup analysis, organophosphorus pesticides (OPs) (pooled OR = 1.14 (95%CI: 1.04 to 1.24)), pyrethroid (pooled OR = 1.40 (95%CI: 1.09 to 1.80)), and maternal age ≥30 years old (pooled OR = 1.24 (95%CI: 1.10 to 1.40)) increased the risk of ASD in offspring. Maternal organochlorine pesticides (OCPs) exposure was a risk factor for ADHD in offspring (pooled OR = 1.22 (95%CI: 1.03 to 1.45)).

CONCLUSION

Maternal pesticide exposure increased the risk of ASD and ADHD in offspring. Moreover, OPs, pyrethroid, and maternal age ≥30 years old were found to be risk factors affecting children's ASD. Maternal exposure to OCPs increased the risk of ADHD in offspring. Our findings contribute to our understanding of health risks related to maternal pesticide exposure and indicate that the in utero developmental period is a vulnerable window-of-susceptibility for ASD and ADHD risk in offspring. These findings should guide policies that limit maternal exposure to pesticides, especially for pregnant women living in agricultural areas.

摘要

目的

分析母体农药暴露与后代自闭症谱系障碍(ASD)和注意缺陷多动障碍(ADHD)的关联。

方法

系统检索了 PubMed、Embase、Web of Science、Medline 和 PsycINFO 这五个数据库,以获取截至 2022 年 8 月 30 日与妊娠期间母体农药暴露以及后代 ASD 和 ADHD 相关的记录。主要亚组包括农药类别、母体年龄和暴露窗口。

结果

最初确定了 949 项研究,最终纳入了 19 项研究。其中 11 项研究涉及 ASD,7 项研究涉及 ADHD,1 项研究同时涉及这两种疾病。母体农药暴露与后代 ASD(汇总 OR=1.19(95%CI:1.04 至 1.36))和 ADHD(汇总 OR=1.20(95%CI:1.04 至 1.38))呈正相关。在亚组分析中,有机磷农药(OPs)(汇总 OR=1.14(95%CI:1.04 至 1.24))、拟除虫菊酯(汇总 OR=1.40(95%CI:1.09 至 1.80))和母体年龄≥30 岁(汇总 OR=1.24(95%CI:1.10 至 1.40))增加了后代患 ASD 的风险。母体有机氯农药(OCPs)暴露是后代 ADHD 的危险因素(汇总 OR=1.22(95%CI:1.03 至 1.45))。

结论

母体农药暴露增加了后代患 ASD 和 ADHD 的风险。此外,OPs、拟除虫菊酯和母体年龄≥30 岁被发现是影响儿童 ASD 的危险因素。母体接触 OCPs 增加了后代患 ADHD 的风险。我们的研究结果有助于了解与母体农药暴露相关的健康风险,并表明宫内发育时期是后代患 ASD 和 ADHD 风险的易感性窗口期。这些发现应指导限制孕妇接触农药的政策,特别是对于生活在农业区的孕妇。

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