Neurodevelopmental performance among school age children in rural Guatemala is associated with prenatal and postnatal exposure to carbon monoxide, a marker for exposure to woodsmoke
Neurodevelopmental performance among school age children in rural Guatemala is associated with prenatal and postnatal exposure to carbon monoxide, a marker for exposure to woodsmoke
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DOI：
10.1016/j.neuro.2011.09.004
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发表时间：
2012-03-01
期刊：
影响因子：
3.4
通讯作者：
Smith, Kirk R.
中科院分区：
文献类型：
--
作者：
Dix-Cooper, Linda;Eskenazi, Brenda;Smith, Kirk R.
我们以个人被动48小时一氧化碳（CO）为指标，研究了早期生活慢性暴露于木材烟雾是否与儿童的神经发育和行为表现有关。2002年至2005年，在危地马拉圣马科斯进行的室内污染和呼吸效应随机暴露研究（RESPIRE）炉子干预试验期间，每3个月收集一次母子组的CO测量值。从2010年3月到6月，研究了6-7岁的儿童，进行了后续的非语言，文化适应神经发育评估。我们发现孕妇在妊娠晚期CO暴露（m = 3.8 ppm +/- 3.0 ppm；范围：0.6-12.5 ppm）与儿童神经心理表现呈负相关。11项神经心理测试中的4项得分与母亲妊娠晚期CO暴露显著相关，包括视觉空间整合（p < 0.05）、短期记忆回忆（p < 0.05）、长期记忆回忆（p < 0.05）和精细运动表现（p < 0.01），这些测试分别采用Bender格式塔- ii副本、即时回忆、延迟回忆图形图的修改版本和Reitan-Indiana手指轻拍测试。这4项重大发现在儿童性别、年龄、视力和家庭资产（社会经济地位）调整后仍然存在。在对这些协变量进行调整后，总结性表现得分也与产妇妊娠晚期CO显著相关。在我们最终的多元回归模型中被排除的其他变量包括：家庭环境刺激评分、儿童检查员、WHO年龄身高百分位数和婴儿停止母乳喂养的年龄。这似乎是第一个关于木材烟雾暴露和神经发育的研究，也是第一个关于慢性早期生命一氧化碳暴露的纵向出生队列研究，通过对母亲和婴儿个人一氧化碳暴露的高质量测量，并使用成熟可靠的儿童神经心理测试来确定。需要进一步的研究来复制我们的结果，并为未来的干预措施和木材烟雾和CO的空气质量标准提供信息。版权所有。
We investigated whether early life chronic exposure to woodsmoke, using personal passive 48-h carbon monoxide (CO) as an indicator, is associated with children's neurodevelopmental and behavioral performance. CO measures were collected every 3 months from 2002 to 2005 among mother-child dyads during the Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) stove intervention trial in San Marcos, Guatemala. From March to June, 2010, study children of age 6-7 years, performed a follow-up non-verbal, culturally adapted neurodevelopmental assessment. We found inverse associations between CO exposure of pregnant mothers during their 3rd trimesters (m = 3.8 ppm +/- 3.0 ppm; range: 0.6-12.5 ppm) and child neuropsychological performance. Scores on 4 out of 11 neuropsychological tests were significantly associated with mothers' 3rd trimester CO exposures, including visuo-spatial integration (p < 0.05), short-term memory recall (p < 0.05), long-term memory recall (p < 0.05), and fine motor performance (p < 0.01) measured using the Bender Gestalt-II's Copy, Immediate Recall, and an adapted version of a Delayed Recall Figures drawing, and the Reitan-Indiana's Finger Tapping Tests, respectively. These 4 significant finding persisted with adjustment for child sex, age, visual acuity, and household assets (socio-economic status). Summary performance scores were also significantly associated with maternal 3rd trimester CO when adjusted for these covariates. Other variables accounting for variance but were excluded in our final multiple regression models included the following: HOME environment stimulation score, child examiner, WHO height-for-age percentile, and age that the infant stopped breastfeeding. This seems to be the first study on woodsmoke exposure and neurodevelopment, and the first longitudinal birth cohort study on chronic early life CO exposures, determined by high quality measures of mothers' and infants' personal CO exposures, and using well-established, reliable child neuropsychological tests. Further research is needed to replicate our results and inform future interventions and air quality standards for woodsmoke and CO. (C) 2011 Elsevier Inc. All rights reserved.