妊娠期全氟化合物暴露与婴儿神经行为发育关联的队列研究  

Associations between prenatal exposure to perfluoroalkyl substances and neurobehavioral development in infants: A cohort study

作　　者：谢珍珍 何更生[1] 栾敏 刘晓敏 曹文成 陈雅菲 袁伟[2] 苗茂华[2] 梁红[2] XIE Zhen-zhen;HE Geng-sheng;LUAN Min;LIU Xiao-min;CAO Wen-cheng;CHEN Ya-fei;YUAN Wei;MIAO Mao-hua;LIANG Hong(Key Laboratory of Public Health Safety of Ministry of Education,School of Public Health,Fudan University,Shanghai 200032,China;Department of Reproductive Epidemiology and Social Medicine,Shanghai Institute of Planned Parenthood Research,NHC Key Lab.of Reproduction Regulation,Shanghai 200237,China;Hubei Provincial Key Laboratory of Applied Toxicology,National Reference Laboratory of Dioxin,Hubei Provincial Center for Disease Control and Prevention,Wuhan,Hubei 430079,China)

机构地区：[1]复旦大学公共卫生学院,公共卫生安全教育部重点实验室,上海200032 [2]上海市计划生育科学研究所流行病学与社会医学研究室,国家卫生健康委员会计划生育药具重点实验室,上海200237 [3]湖北省疾病预防控制中心二噁英国家参比实验室,湖北省应用毒理学重点实验室,湖北武汉430079

出　　处：《环境与职业医学》2020年第6期530-538,共9页Journal of Environmental and Occupational Medicine

基　　金：国家自然科学基金项目(81703194);上海市自然科学基金项目(16ZR1430100);国家卫生健康委员会计划生育药具重点实验室科技创新导向项目(CX2017-06)。

摘　　要：[背景]全氟化合物(PFASs)是一类新型持久性有机污染物。孕妇血液和羊水中均可检出该类物质,提示子代胎儿期即可暴露于PFASs。而目前关于孕期PFASs暴露对子代神经行为发育作用的人群流行病学研究结果不一致。[目的]探讨妊娠期PFASs暴露与婴儿神经行为发育之间的关联。[方法]基于2012年4—12月在上海闵行区妇幼保健院建立的闵行出生队列,本研究纳入646对母婴。使用高效液相色谱-串联质谱法测定孕妇(孕12—16周)血浆中11种PFASs质量浓度(后称为浓度),包括全氟己烷磺酸(PFHxS)、全氟辛烷磺酸(PFOS)、全氟辛酸(PFOA)、全氟壬酸(PFNA)、全氟癸酸(PFDA)、全氟十一烷酸(PFUdA)、全氟十二烷酸(PFDoA)、全氟十三烷酸(PFTrDA)、全氟十四烷酸(PFTeDA)、全氟十六烷酸(PFHxDA)和全氟癸烷磺酸(PFDS)。当婴儿6月龄时,通过家访向父母或其他看护人员询问完成年龄与发育进程问卷(ASQ-3)以评估其神经行为发育状况。采用稳健的泊松回归模型分析母亲妊娠期PFASs暴露与婴儿6月龄ASQ-3的每个能区发育问题/延迟之间的关联。[结果]646例孕妇体内8种PFASs检出率超过85%。PFOA和PFOS的浓度最高,中位数浓度分别为19.76μg·L^-1和10.67μg·L^-1。母亲孕期血浆PFOS、PFSA(包括PFHxS和PFOS)和∑PFASs的浓度(经自然对数转换后)与婴儿精细动作能区发育问题/延迟的发生风险呈正相关,调整后相对危险度(aRR)及其95%可信区间(95%CI)分别为1.60(1.03~2.48)、1.90(1.19~3.04)和2.11(1.16~3.83)。性别分层后发现母亲血浆PFOS、PFSA和∑PFASs浓度越高,女婴精细动作和解决问题能区发育问题/延迟的发生风险越高:精细动作能区,aRRPFOS(95%CI)为2.89(1.50~5.58),aRRPFSA(95%CI)为4.10(2.00~8.40),aRR∑PFASs(95%CI)为3.37(1.37~8.30);解决问题能区,aRRPFOS(95%CI)为1.82(1.06~3.13),aRRPFSA(95%CI)为2.22(1.17~4.23),aRR∑PFASs(95%CI)为2.25(1.07~4.73)。男婴中未发现PFASs浓度与各能区发育问题/[Background]Perfluoroalkyl substances(PFASs)are persistent pollutants.These substances can be detected in pregnant women’s blood and amniotic fluid,suggesting that offspring are exposed to PFASs during the fetal period.The associations between maternal PFASs exposure and neurobehavioral development in children are inconclusive.[Objective]To examine the associations between maternal PFASs exposure during pregnancy and neurobehavioral development in infants.[Methods]A total of 646 mother-infant pairs were included in the present study,based on the Shanghai-Minhang Birth Cohort Study which was conducted between April and December 2012 at the Maternal and Child Health Hospital of Minhang District in Shanghai.Eleven PFASs in pregnant women’s blood(gestational 12-16 weeks),including perfluorohexane sulfonate(PFHx S),perfluorooctane sulfonate(PFOS),perfluorooctanoic acid(PFOA),perfluorononanoic acid(PFNA),perfluorodecanoic acid(PFDA),perfluoroundecanoic acid(PFUd A),perfluorododecanoic acid(PFDo A),perfluorotridecanoic acid(PFTr DA),perfluorotetradecanoic acid(PFTe DA),perfluorohexadecanoic acid(PFHx DA),and perfluorodecane sulfonate(PFDS),were quantified by high performance liquid chromatography coupled with tandem mass spectrometry.When the infants turned 6 months old,their parents or other caregivers were asked to complete the Ages and Stages Questionnaires(ASQ-3)to assess neurobehavioral development of their children at a home visit.Poisson regression model with robust variance estimates was used to examine the associations between maternal PFASs concentrations and each developmental problems/delay subscale of the ASQ-3.[Results]The positive rates of eight PFASs in the 646 pregnant women exceeded 85%.The highest concentration was found in PFOA and followed by PFOS,with the median concentrations of 19.76μg·L^-1 and 10.67μg·L^-1,respectively.Concentrations of PFOS,PFSA(PFHx S and PFOS),and∑PFASs(after natural log transformation)tended to be positively associated with developmental problems/delay in the fine

关 键 词：全氟化合物 妊娠期暴露 婴儿 神经行为发育 队列研究 

分 类 号：R12[医药卫生—环境卫生学]