Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
Operating Room, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
BMC Public Health. 2024 Feb 20;24(1):533. doi: 10.1186/s12889-024-17946-8.
Previous studies of singletons evaluating prenatal phthalate exposure and early neurodevelopment reported mixed results and the associations could be biased by parental, obstetrical, and genetic factors.
A co-twin control design was employed to test whether prenatal phthalate exposure was associated with children's neurocognitive development. We collected information from 97 mother-twin pairs enrolled in the Wuhan Twin Birth Cohort between March 2016 and October 2018. Fourteen phthalate metabolites were measured in maternal urine collected at each trimester. Neurodevelopmental differences in twins at the age of two were examined as the outcome of interest. Multiple informant model was used to examine the covariate-adjusted associations of prenatal phthalate exposure with mental development index (MDI) and psychomotor development index (PDI) scores assessed at 2 years of age based on Bayley Scales of Infant Development (Second Edition). This model also helps to identify the exposure window of susceptibility.
Maternal urinary levels of mono-2-ethyl-5-oxohexyl phthalate (MEOHP) (β = 1.91, 95% CI: 0.43, 3.39), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) (β = 1.56, 95% CI: 0.33, 2.79), and the sum of di-(2-ethylhexyl) phthalate metabolites (∑DEHP) (β = 1.85, 95% CI: 0.39, 3.31) during the first trimester showed the strongest and significant positive associations with intra-twin MDI difference. When stratified with twin chorionicity, the positive associations of monoethyl phthalate (MEP), monoisobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), individual DEHP metabolites, and ∑DEHP exposure during pregnancy with intra-twin neurodevelopmental differences were more significant in monochorionic diamniotic (MCDA) twins than those in dichorionic diamniotic (DCDA) twins.
Neurodevelopmental differences in MCDA twins were strongly associated with prenatal phthalate exposure. Our findings warrant further confirmation in longitudinal studies with larger sample sizes.
之前评估产前邻苯二甲酸酯暴露与早期神经发育的单胎研究结果不一，且这些关联可能受到父母、产科和遗传因素的影响。
采用同卵双生子对照设计来检验产前邻苯二甲酸酯暴露是否与儿童神经认知发育有关。我们收集了 2016 年 3 月至 2018 年 10 月期间参加武汉双胎出生队列的 97 对母婴的信息。在每个孕期采集母亲尿液，检测 14 种邻苯二甲酸酯代谢物。以贝利婴幼儿发展量表（第二版）评估的 2 岁时的精神发育指数（MDI）和精神运动发育指数（PDI）为因变量，采用多信息模型检验产前邻苯二甲酸酯暴露与 2 岁时神经发育的相关性。该模型还可以帮助确定易感暴露窗口。
母亲尿液中的单-2-乙基-5-氧己基邻苯二甲酸酯（MEOHP）（β=1.91，95%CI：0.43，3.39）、单（2-乙基-5-羟基己基）邻苯二甲酸酯（MEHHP）（β=1.56，95%CI：0.33，2.79）和邻苯二甲酸二（2-乙基己基）代谢物总和（∑DEHP）（β=1.85，95%CI：0.39，3.31）在孕早期与同卵双生子 MDI 差值呈最强和显著正相关。按双胎绒毛膜性分层后，妊娠期间邻苯二甲酸单乙基酯（MEP）、邻苯二甲酸单异丁酯（MiBP）、邻苯二甲酸单正丁酯（MBP）、邻苯二甲酸单苄基酯（MBzP）、个别 DEHP 代谢物和∑DEHP 与同卵双生子神经发育差异的正相关在单绒毛膜双羊膜（MCDA）双胞胎中比双绒毛膜双羊膜（DCDA）双胞胎中更为显著。
MCDA 双胞胎的神经发育差异与产前邻苯二甲酸酯暴露密切相关。我们的研究结果需要在具有更大样本量的纵向研究中进一步证实。
