Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, 0213 Oslo, Norway.
Int J Environ Res Public Health. 2022 Dec 15;19(24):16851. doi: 10.3390/ijerph192416851.
Prenatal organophosphorus pesticides (OPs) are ubiquitous and have been linked to adverse neurodevelopmental outcomes. However, few studies have examined prenatal OPs in relation to diagnosed attention-deficit/hyperactivity disorder (ADHD), with only two studies exploring this relationship in a population primarily exposed through diet. In this study, we used a nested case-control study to evaluate prenatal OP exposure and ADHD diagnosis in the Norwegian Mother, Father, and Child Cohort Study (MoBa). For births that occurred between 2003 and 2008, ADHD diagnoses were obtained from linkage of MoBa participants with the Norwegian Patient Registry (N = 297), and a reference population was randomly selected from the eligible population (N = 552). Maternal urine samples were collected at 17 weeks' gestation and molar sums of diethyl phosphates (ΣDEP) and dimethyl phosphates metabolites (ΣDMP) were calculated. Multivariable adjusted logistic regression models were used to estimate the association between prenatal OP metabolite exposure and child ADHD diagnosis. Additionally, multiplicative effect measure modification (EMM) by child sex was assessed. In most cases, mothers in the second and third tertiles of ΣDMP and ΣDEP exposure had slightly lower odds of having a child with ADHD, although confidence intervals were wide and included the null. EMM by child sex was not observed for either ΣDMP or ΣDEP. In summary, we did not find evidence that OPs at 17 weeks' gestation increased the odds of ADHD in this nested case-control study of ADHD in MoBa, a population primarily experiencing dietary exposure.
产前有机磷农药(OPs)普遍存在,与不良神经发育结局有关。然而,很少有研究探讨产前 OPs 与已确诊的注意缺陷多动障碍(ADHD)之间的关系,仅有两项研究在主要通过饮食暴露的人群中探索了这种关系。在这项研究中,我们使用嵌套病例对照研究来评估挪威母亲、父亲和儿童队列研究(MoBa)中产前 OP 暴露与 ADHD 诊断之间的关系。对于 2003 年至 2008 年期间出生的婴儿,通过将 MoBa 参与者与挪威患者登记处(N=297)进行链接,获得 ADHD 诊断,并且从合格人群中随机选择参考人群(N=552)。在妊娠 17 周时采集母亲尿液样本,并计算二乙基磷酸酯(ΣDEP)和二甲基磷酸酯代谢物(ΣDMP)的总量。使用多变量调整的逻辑回归模型来估计产前 OP 代谢物暴露与儿童 ADHD 诊断之间的关联。此外,还评估了儿童性别对乘积效应度量修饰(EMM)的影响。在大多数情况下,ΣDMP 和 ΣDEP 暴露处于第二和第三三分位的母亲,其子女患 ADHD 的几率略低,但置信区间较宽,包括无效值。未观察到儿童性别对 ΣDMP 或 ΣDEP 的 EMM 作用。综上所述,在 MoBa 中进行的 ADHD 嵌套病例对照研究中,我们没有发现妊娠 17 周时 OPs 会增加 ADHD 发病风险的证据,该人群主要通过饮食暴露。