Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
Chemosphere. 2024 Jan;347:140367. doi: 10.1016/j.chemosphere.2023.140367. Epub 2023 Oct 25.
Polybrominated diphenyl ethers (PBDEs) are flame retardants found in ambient environment and are measured in humans. There are reports on general PBDE toxicity, including endocrine disrupting properties. Studies on adverse maternal and infant outcomes and underlying toxicity mechanisms needs to be understood. The objective of this study was to conduct a systematic review to examine the state of science on the relationship between PBDE and adverse maternal/infant health outcomes and related maternal biomarker changes. This literature review was conducted using PubMed, Scopus, Embase and Web of Science for published articles from January 2005-February 2022. Article quality was assessed using Newcastle-Ottawa Scale. Of the 1518 articles, only 54 human observational studies were screened in for this review. A second reviewer examined the validity of these articles. Reports on associations between PBDE and maternal health outcomes included gestational hypertension/preeclampsia (N = 2) and gestational diabetes mellitus/glycemic index (N = 6). Meanwhile, reports on PBDE and infant outcomes (N=32) included effects on infant birth weight, birth length and cephalic perimeter, preterm birth, fetal growth restriction and APGAR scores. Although findings on PBDE exposure and adverse infant outcomes showed inconsistencies across studies, in general, negative correlations between maternal PBDEs and infant birth weight, birth length and cephalic perimeter were seen, in few cases, after stratification by sex. Association between maternal PBDE and maternal biomarkers (N=18) suggested negative impact of PBDE exposure on markers relevant to neuro-endocrine system and inflammatory processes. The review findings identified potential associations between maternal PBDE and adverse maternal/infant health outcomes. Furthermore, PBDE-related biomarker changes suggest disturbances in maternal mechanisms relevant to endocrine disrupting properties of PBDEs. The observed study heterogeneity can be attributed to factors namely, sample size, study design and statistical analysis. Overall review findings imply the necessity for further research to validate PBDE exposure-related adverse maternal/infant health effects and to validate underlying toxicity mechanisms.
多溴二苯醚（PBDEs）是一种存在于环境中的阻燃剂，可在人体中测量到。已有关于 PBDE 一般毒性的报告，包括内分泌干扰特性。需要了解不良母婴结局和潜在毒性机制的研究。本研究的目的是进行系统评价，以检查 PBDE 与不良母婴健康结局之间关系的研究现状以及相关的母体生物标志物变化。本文献综述使用 PubMed、Scopus、Embase 和 Web of Science 对 2005 年 1 月至 2022 年 2 月期间发表的文章进行了检索。使用纽卡斯尔-渥太华量表评估文章质量。在 1518 篇文章中，只有 54 项人类观察性研究被筛选入本次综述。第二名评审员检查了这些文章的有效性。关于 PBDE 与产妇健康结局之间关系的报告包括妊娠高血压/先兆子痫（N=2）和妊娠糖尿病/血糖指数（N=6）。同时，关于 PBDE 和婴儿结局的报告（N=32）包括对婴儿出生体重、出生长度和头围、早产、胎儿生长受限和 APGAR 评分的影响。尽管 PBDE 暴露与不良婴儿结局之间的研究结果不一致，但总体而言，在少数情况下，在按性别分层后，观察到母体 PBDE 与婴儿出生体重、出生长度和头围之间存在负相关。母体 PBDE 与母体生物标志物之间的关联（N=18）表明 PBDE 暴露对与神经内分泌系统和炎症过程相关的标志物有负面影响。综述结果确定了母体 PBDE 与不良母婴健康结局之间的潜在关联。此外，与 PBDE 相关的生物标志物变化表明，母体机制受到干扰，与 PBDE 的内分泌干扰特性有关。观察到的研究异质性可归因于以下因素，即样本量、研究设计和统计分析。总体综述结果表明，有必要进一步研究验证 PBDE 暴露相关的母婴不良健康影响，并验证潜在的毒性机制。
