Jacobson J L, Jacobson S W
Wayne State University, Detroit, MI 48202, USA.
Neurotoxicology. 1997;18(2):415-24.
Neurobehavioral effects of prenatal exposure to polychlorinated biphenyls (PCBs) have been investigated most extensively in two prospective longitudinal studies--one in North Carolina, the other in Michigan. Based on the Webb-McCall methodology available when these studies were initiated, a majority of the cord serum PCB concentrations in both cohorts were below laboratory detection limits. Prenatal exposure was, therefore, assessed in North Carolina in terms of maternal body burden and, in a recent 11-year follow-up in Michigan, by averaging detectable PCB values from cord and maternal serum and maternal milk samples. The new composite prenatal exposure measure used in Michigan at 11 years was more valid in relation to maternal contaminated fish consumption and more sensitive in detecting 4-year cognitive deficits than the cord serum measure used in earlier phases of the study. During infancy, the North Carolina study found poorer gross motor function in relation to prenatal PCB exposure; the Michigan study found poorer infant visual recognition memory, an effect confirmed in a sample of Taiwanese infants exposed to PCBs and polychlorinated dibenzofurans (PCDFs) due to maternal ingestion of highly contaminated rice oil. Cognitive deficits found at 4 years in Michigan were not seen in North Carolina, possibly due to a different pattern of exposure or a different congener mix. An examination of the incidence of functionally-significant impairment (defined as > 1 SD below the sample mean) showed that the more highly exposed Michigan children were twice as likely to perform poorly than others in the sample and that there are marked individual differences in vulnerability to this exposure. Thus, a small reduction in a mean IQ score may reflect little effect on a majority of the sample, accompanied by a substantial deficit in a small number of more vulnerable children.
产前接触多氯联苯(PCBs)对神经行为的影响在两项前瞻性纵向研究中得到了最为广泛的调查——一项在北卡罗来纳州,另一项在密歇根州。基于这些研究启动时可用的韦伯-麦考尔方法,两个队列中大多数脐带血清多氯联苯浓度都低于实验室检测限。因此,在北卡罗来纳州,产前接触是根据母体身体负担来评估的;而在密歇根州最近的一项为期11年的随访中,则是通过对脐带血、母体血清和母乳样本中可检测到的多氯联苯值进行平均来评估的。密歇根州在11年时使用的新的综合产前接触测量方法,与母体食用受污染鱼类的情况相比更有效,并且在检测4岁儿童的认知缺陷方面比该研究早期阶段使用的脐带血清测量方法更敏感。在婴儿期,北卡罗来纳州的研究发现,产前接触多氯联苯与较差的粗大运动功能有关;密歇根州的研究发现婴儿视觉识别记忆较差,这一效应在因母亲摄入高度污染的米糠油而接触多氯联苯和多氯二苯并呋喃(PCDFs)的台湾婴儿样本中得到了证实。密歇根州4岁儿童出现的认知缺陷在北卡罗来纳州并未出现,这可能是由于接触模式不同或同系物组合不同所致。对功能显著受损(定义为低于样本均值1个标准差以上)发生率的检查表明,接触程度较高的密歇根州儿童表现不佳的可能性是样本中其他儿童的两倍,而且在对这种接触的易感性方面存在明显的个体差异。因此,平均智商得分的小幅下降可能对大多数样本影响不大,但少数更易受影响的儿童会出现明显的缺陷。