Gender specific differences in neurodevelopmental effects of prenatal exposure to very low-lead levels: the prospective cohort study in three-year olds.
Gender specific differences in neurodevelopmental effects of prenatal exposure to very low-lead levels: the prospective cohort study in three-year olds.
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DOI：
10.1016/j.earlhumdev.2009.04.006
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发表时间：
2009-08
影响因子：
2.5
通讯作者：
Lisowska-Miszczyk, Ilona
中科院分区：
文献类型：
--
作者：
Jedrychowski, Wieslaw;Perera, Frederica;Jankowski, Jeffery;Mrozek-Budzyn, Dorota;Mroz, Elzbieta;Flak, Elzbieta;Edwards, Susan;Skarupa, Anita;Lisowska-Miszczyk, Ilona
这项研究的主要目的是评估脐带血中测量的极低水平的产前铅暴露（<5 µg/dL）与生命最初三年中可能的性别特异性认知缺陷之间的关系。通过脐带血铅水平（BLL）测量妊娠期婴儿的累积铅剂量，并通过贝利智力发育指数（MDI）评估认知缺陷。研究样本包括457名儿童出生的非吸烟妇女生活在内城和克拉科夫的外围住宅区。采用线性多元回归和广义估计方程（GEE）纵向面板模型，评估了产前铅暴露与12、24和36个月龄时测量的MDI评分之间的关系，并调整了一组重要的协变量（儿童性别、母亲教育、产次、母乳喂养、产前和产后环境烟草烟雾）。脐带血铅水平中位数为1.21 µg/dL，范围为0.44 - 4.60 µg/dL。产前BLL（中位数二分）或其他协变量均不影响12月龄时的MDI评分。随后对24个月大的儿童进行的测试显示，铅暴露与心理功能呈显著负相关（β系数）。=-2.42，95%CI：-4.90至0.03），但交互作用项（BLL ×男性）不显著。在36个月时，产前铅暴露与男孩的认知功能呈显著负相关（斯皮尔曼相关系数=-0.239，p=0.0007），但与女孩无关（r =-0.058，p = 0.432），BLL与男性性别之间的相互作用显著（β系数=-0.058，p = 0.432）。= − 4.46; 95%CI：−8.28至−0.63）。与最低四分位数的暴露（β系数）相比，36个月时男孩MDI缺陷的调整估计值证实了产前铅暴露（BLL>1.67µg/dL）的非常强烈的负面影响。=-6.2，p = 0.002），但对女孩的影响不显著（β系数=-0.74，p = 0.720）。在出生后的前三年，总样本中认知功能的平均缺陷（GEE模型）与产前铅暴露量较高相关，也很显著（β系数= − 3.00; 95%CI：−5.22至−0.70）。除产前铅暴露外，家中有年长的兄弟姐妹和产前吸烟环境对MDI评分有负面影响。更好的母亲教育对儿童的认知发展有很大的有益影响。结论：这项研究表明，儿童铅中毒可能没有阈值，并提供证据表明，3岁的男孩比女孩更容易受到产前极低铅暴露的影响。这项研究的结果应能说服决策者在制定环境保护准则时考虑到与性别有关的对铅和可能对其他有毒危害的敏感性。为了确定本研究中记录的认知缺陷是否持续到老年，将在未来几年内对儿童进行随访。
The primary purpose of this study was to assess the relationship between very low-level of prenatal lead exposure measured in the cord blood (<5 µg/dL) and possible gender-specific cognitive deficits in the course of the first three years of life. The accumulated lead dose in infants over the pregnancy period was measured by the cord blood lead level (BLL) and cognitive deficits were assessed by the Bayley Mental Development Index (MDI). The study sample consisted of 457 children born to non-smoking women living in the inner city and the outlying residential areas of Krakow. The relationship between prenatal lead exposure and MDI scores measured at 12, 24 and 36 months of age and adjusted to a set of important covariates (gender of child, maternal education, parity, breastfeeding, prenatal and postnatal environmental tobacco smoke) was evaluated with linear multivariate regression, and the Generalized Estimating Equations (GEE) longitudinal panel model. The median of lead level in cord blood was 1.21 µg/dL with the range of values from 0.44 to 4.60 µg/dL. Neither prenatal BLL (dichotomized by median) nor other covariates affected MDI score at 12 months of age. Subsequent testing of children at 24 months of age showed a borderline significant inverse association of lead exposure and mental function (beta coeff. = −2.42, 95%CI: −4.90 to 0.03), but the interaction term (BLL × male gender) was not significant. At 36 months, prenatal lead exposure was inversely and significantly associated with cognitive function in boys (Spearman correlation coefficient = −0.239, p=0.0007) but not girls (r = − 0.058, p = 0.432) and the interaction between BLL and male gender was significant (beta coeff. = − 4.46; 95%CI: −8.28 to −0.63). Adjusted estimates of MDI deficit in boys at 36 months confirmed very strong negative impact of prenatal lead exposure (BLL>1.67µg/dL) compared with the lowest quartile of exposure (beta coeff. = −6.2, p = 0.002), but the effect in girls was insignificant (beta coeff = −0.74, p = 0.720). The average deficit of cognitive function in the total sample over the first three years of life (GEE model) associated with higher prenatal lead exposure was also significant (beta coefficient = − 3.00; 95%CI: −5.22 to −0.70). Beside prenatal lead exposure, presence of older siblings at home and prenatal environmental tobacco smoke had a negative impact on MDI score. Better maternal education showed a strong beneficial effect on the cognitive development of children. Conclusion: The study suggests that there might be no threshold for lead toxicity in children and provides evidence that 3-year old boys are more susceptible than girls to prenatal very low lead exposure. The results of the study should persuade policy makers to consider gender-related susceptibility to lead and possibly to other toxic hazards in setting environmental protection guidelines. To determine whether the cognitive deficit documented in this study persists to older ages, the follow-up of the children over the next several years is to be carried out.
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影响因子：
2.9
作者：
ROTHENBERG, SJ;SCHNAAS, L;SVENDSGAARD, D
通讯作者：
SVENDSGAARD, D
影响因子：
158.5
作者：
Canfield, RL;Henderson, CR;Lanphear, BP
通讯作者：
Lanphear, BP
影响因子：
3.4
作者：
Surkan, Pamela J.;Schnaas, Lourdes;Wright, Robert O.
通讯作者：
Wright, Robert O.
DOI：
10.2478/v10001-006-0034-5
发表时间：
2006-01-01
影响因子：
2
作者：
Jedrychowski, Wieslaw;Flak, Elzbieta;Perera, Frederica
通讯作者：
Perera, Frederica
在城市内部儿童生命的前三年中，产前暴露于空气中多环芳烃对神经发育的影响。
影响因子：
10.4
作者：
Perera, Frederica P;Rauh, Virginia;Whyatt, Robin M;Tsai, Wei-Yann;Tang, Deliang;Diaz, Diurka;Hoepner, Lori;Barr, Dana;Tu, Yi-Hsuan;Camann, David;Kinney, Patrick
通讯作者：
Kinney, Patrick