Neuropsychological assessment at school-age and prenatal low-level exposure to mercury through fish consumption in an Italian birth cohort living near a contaminated site
Neuropsychological assessment at school-age and prenatal low-level exposure to mercury through fish consumption in an Italian birth cohort living near a contaminated site
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DOI：
10.1016/j.ijheh.2013.02.004
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发表时间：
2013-07-01
影响因子：
6
通讯作者：
Barbone, F.
中科院分区：
文献类型：
--
作者：
Deroma, L.;Parpinel, M.;Barbone, F.
产前和产后低水平汞暴露和鱼类摄入对儿童神经发育的相对影响仍然存在争议。从地中海人群中获得的证据有限。在这项前瞻性研究中，我们测量了意大利学龄儿童的语言和表现智商，他们居住在一个因汞污染而被宣布为国家污染场地的地区，同时考虑到鱼类消费和潜在混杂因素的可能有益影响。2001年，在意大利东北部建立了一个由242名儿童组成的母婴队列。她们的母亲在分娩后约2个月接受了采访，以确定怀孕期间食用鱼的类型、数量和来源，以及一些母亲、儿童和家庭特征。对母亲头发、母乳和儿童头发中的总汞（THg）和甲基汞（MeHg）进行了评估。当儿童达到7-9岁时，154名（63.6%）父母同意参加后续评估。在这种情况下，收集了一个孩子的头发样本，以确定目前的THg浓度，母亲被要求完成一个自我管理的问卷，儿童进行神经心理测试。言语智商、操作智商和全面智商由学校或当地卫生中心的心理学家使用韦氏儿童智力量表（WISC III）进行测量。通过母亲填写的调查问卷收集儿童的人口统计学、社会经济学和生活方式信息、儿童家庭的医疗信息以及儿童的饮食习惯。多变量线性回归模型被用来评估产前THg暴露之间的关联，通过鱼消费的母亲在怀孕期间和儿童的智商调整后，可能的混杂因素，如鱼消费的母亲在怀孕期间，儿童的鱼消费在后续，儿童的出生体重，母亲吸烟在怀孕期间，房屋大小和财产的居住地在怀孕期间和性别。7岁时儿童头发中的THg与分娩时母亲头发中的THg相当相关（r（s）= 0.35; p < 0.0001），并且与儿童的海鲜消费强烈相关（r（s）= 0.50，p < 0.0001）。母亲THg水平没有差异时，发现比较低或极低或高或极高的分数与其他儿童，分别考虑全面，言语和性能智商。母亲的头发THg水平大于或等于2000 ng/g的孩子有全面的，言语和操作智商比母亲低4-5分THg水平，但这些差异没有统计学意义。鲜鱼摄入量的母亲在怀孕期间略有积极与全面和性能，但不是这样的语言智商。罐头鱼与所有结果变量呈负相关。出乎意料的是，来自一个城镇的母亲所生的孩子的智商得分明显低于其他孩子;然而，在这些分析中考虑的许多变量都无法解释这一结果。在生物样本中发现的汞含量相对较低，并不能证明这一人群中存在大量汞暴露。虽然母亲和孩子的生物样本中的THg水平与鱼类消费相关，但THg和鱼类对神经系统结果的影响是相反的。这些结果不允许制定关于怀孕期间鱼类消费的建议，但建议保持THg毛发水平
The relative effects of prenatal and postnatal low-level mercury exposure and fish intake on child neurodevelopment are still controversial. Limited evidence is available from Mediterranean populations. In this prospective study, we measured the Verbal and Performance IQ in Italian children at school-age who were resident in an area declared as a National contaminated site because of mercury pollution, taking into account the possible beneficial effect of fish consumption and potential confounders. A mother-child cohort made up of 242 children was established at birth in Northeastern Italy in 2001. Their mothers were interviewed approximately 2 months after delivery to determine type, quantity, and origin of fish consumed during pregnancy and about a number of mother, child and family characteristics. Total mercury (THg) and methyl mercury (MeHg) were assessed in maternal hair and breast milk and in the child's hair. When children reached 7-9 years of age, 154 (63.6%) parents gave consent to participate in a follow-up evaluation. On that occasion, a child's hair sample was collected to determine the current concentration of THg, mothers were asked to complete a self-administered questionnaire, and children underwent neuropsychological testing. Verbal IQ, performance IQ and full scale IQ were measured by the Wechsler Intelligence Scale for Children (WISC III) administered by psychologists at school or local health centers. Demographic, socioeconomic and lifestyle information, medical information of the child's family and the child's dietary habits were collected using a questionnaire filled in by mothers. Multivariable linear regression models were used to evaluate the association between prenatal THg exposure through fish consumption of mothers in pregnancy and children's IQ after adjustment for possible confounders such as fish consumption of mothers in pregnancy, child's fish consumption at follow-up, child's birthweight, maternal cigarette smoking during pregnancy, house size and property place of residence during pregnancy and gender. THg in the child's hair at 7 years of age was fairly correlated with THg in maternal hair at delivery (r(s) = 0.35; p < 0.0001) and was strongly correlated with child's seafood consumption (r(s) = 0.50, p < 0.0001). No differences in maternal THg levels were found when comparing children with low or extremely low or high or extremely high scores vs others, considering separately full scale, verbal, and performance IQs. Children born from mothers with hair THg levels greater than or equal to 2000 ng/g had full scale, verbal and performance IQs which were 4-5 points lower than children born from women with lower THg levels, but these differences were not statistically significant. Fresh fish intake of mothers in pregnancy was slightly positively associated with full scale and performance but not so with verbal IQs. Canned fish showed to be negatively associated with all the outcome variables. Unexpectedly, children born to mothers from one town showed IQ scores significantly lower than the other children; however, none of the many variables considered in these analyses could explain this result. The relatively low Hg levels found in the biological samples did not provide evidence of high and extensive Hg exposure in this population. Although THg levels in maternal and child's biological samples are correlated with fish consumption, the effects of THg and fish on neurological outcomes go in opposite directions.These results do not allow to develop recommendations regarding fish consumption in pregnancy but suggest that keeping,THg hair levels