Cumulative effects of prenatal-exposure to exogenous chemicals and psychosocial stress on fetal growth: Systematic-review of the human and animal evidence.
Cumulative effects of prenatal-exposure to exogenous chemicals and psychosocial stress on fetal growth: Systematic-review of the human and animal evidence.
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DOI：
10.1371/journal.pone.0176331
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Woodruff TJ
中科院分区：
文献类型：
--
作者：
Vesterinen HM;Morello-Frosch R;Sen S;Zeise L;Woodruff TJ
产前压力或环境化学物暴露对胎儿生长的不良影响已有详尽描述，然而它们的综合影响仍不明确。
对产前压力和化学物暴露对发育结果的综合影响及相互作用进行系统综述。
我们采用了《导航指南》系统综述的前三个步骤。我们撰写了一份方案，进行了全面的文献检索以确定相关的动物和人类研究，并提取了有关发育结果的数据。对于最常见的结果（胎儿生长），我们评估了偏倚风险，计算了个体暴露和联合暴露的主要影响的效应量，并对那些报告了吸烟和社会经济地位（SES）与低出生体重（LBW）几率相关的研究进行了随机效应荟萃分析。
我们确定了17项关于化学物和压力联合暴露与胎儿生长的人类研究和22项动物研究。人类研究在九个方面往往具有较低的偏倚风险。一般来说，我们发现化学物的影响比压力更强，并且这些暴露与低压力组胎儿生长减缓有关，在高压力组这种关联往往更强，但效应修正的证据有限。我们发现吸烟与低出生体重的几率显著增加有关，与低压力（高社会经济地位；比值比1.95（95%置信区间1.53 - 2.48））相比，高压力（低社会经济地位；比值比4.75（2.46 - 9.16））的影响更大。动物研究通常具有较高的偏倚风险，没有显著的综合效应或效应修正。
我们发现，尽管人们担心环境化学物和压力的综合影响，但这仍然是一个研究不足的课题，不过现有的有限人类研究表明，化学物暴露比压力的影响更强，而且在有压力的情况下这种影响通常更大。
Adverse effects of prenatal stress or environmental chemical exposures on fetal growth are well described, yet their combined effect remains unclear. To conduct a systematic review on the combined impact and interaction of prenatal exposure to stress and chemicals on developmental outcomes. We used the first three steps of the Navigation Guide systematic review. We wrote a protocol, performed a robust literature search to identify relevant animal and human studies and extracted data on developmental outcomes. For the most common outcome (fetal growth), we evaluated risk of bias, calculated effect sizes for main effects of individual and combined exposures, and performed a random effects meta-analysis of those studies reporting on odds of low birthweight (LBW) by smoking and socioeconomic status (SES). We identified 17 human- and 22 animal-studies of combined chemical and stress exposures and fetal growth. Human studies tended to have a lower risk of bias across nine domains. Generally, we found stronger effects for chemicals than stress, and these exposures were associated with reduced fetal growth in the low-stress group and the association was often greater in high stress groups, with limited evidence of effect modification. We found smoking associated with significantly increased odds of LBW, with a greater effect for high stress (low SES; OR 4.75 (2.46–9.16)) compared to low stress (high SES; OR 1.95 (95% CI 1.53–2.48)). Animal studies generally had a high risk of bias with no significant combined effect or effect modification. We found that despite concern for the combined effects of environmental chemicals and stress, this is still an under-studied topic, though limited available human studies indicate chemical exposures exert stronger effects than stress, and this effect is generally larger in the presence of stress.
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DOI：
10.1080/07315724.2004.10719428
发表时间：
2004-12-01
影响因子：
3.5
作者：
Barker, DJP
通讯作者：
Barker, DJP
影响因子：
10.4
作者：
Cory-Slechta DA;Virgolini MB;Thiruchelvam M;Weston DD;Bauter MR
通讯作者：
Bauter MR
影响因子：
2.9
作者：
Colomina, MT;Albina, ML;Corbella, J
通讯作者：
Corbella, J
影响因子：
6.2
作者：
Cardwell, Michael S.
通讯作者：
Cardwell, Michael S.
影响因子：
2.8
作者：
DASILVA, AAM;GOMES, UA;BARBIERI, MA
通讯作者：
BARBIERI, MA