首页 >>2016年02期
孕期环境暴露与儿童发育和健康
作者:陶舒曼 陶芳标

摘要:

孕期环境暴露对胎儿生长及儿童发育的负面效应已经得到证实,国内外研究均表明孕期环境暴露对胎儿生长发育、出生结局和儿童心理、行为及神经发育具有较大的影响。本文根据暴露的不同类型,重点从环境化学物、孕期不良生活方式及行为、孕期应激和其他因素等四个方面对环境暴露条件下胎儿或儿童的关键问题进行综述,探讨了环境因素对婴幼儿生长发育、儿童心理、行为、社会及认知方面的不良影响,如出生缺陷、孤独症谱系障碍、注意缺陷多动障碍、情绪问题、学习障碍及智力发育等,并提出未来应进一步加强环境暴露对儿童健康负面影响的发生机制研究。

关键词:环境暴露;内分泌干扰物;应激;妊娠结局

Abstract:

The negative effects of environmental exposure during pregnancy on fetal growth and children development have been confirmed. It has been found that environmental exposures during pregnancy have a great influence on the growth and development of fetus, birth outcomes and children's psychology, behavior and neural development. In this review, according to different types of environmental exposures, we focused on the key issues of the fetus or children induced by four aspects of environment exposure, including environmental chemicals, unhealthy life styles and behaviors, stress and other risk factors, and discussed the adverse effects of environmental factors on the growth and development of infants, children's psychology, behavior, social and cognitive, such as birth defects, autism spectrum disorders, attention deficit hyperactivity disorder, emotional problems, learning disorder and intelligence development and so on. We also suggested that the researches on mechanism of the negative effects of environmental exposure on children's health should be strengthened in the future.

Key words: Environmental exposure;Endocrine disruptors;Stress;Pregnancy outcome

发表日期:2016/2

引用本文:

图/表:

    暂无图表

参考文献:

[1]曹巧玲,张俊明,高志贤,等.环境内分泌干扰物研究的进展[J].中华预防医学杂志,2007,41(3):224-226.
[2]CostaEM, SpritzerPM, HohlA, et al. Effects of endocrine disruptors in the development of the female reproductive tract[J]. Arq Bras Endocrinol Metabol, 2014, 58(2): 153-161. DOI: 10.1590/0004-2730000003031.
[3]ZoellerRT. Endocrine disruptors: do family lines carry an epigenetic record of previous generations' exposures?[J]. Endocrinology, 2006, 147(12): 5513-5514. DOI: 10.1210/en.2006-1282.
[4]BraunJM, YoltonK, DietrichKN, et al. Prenatal bisphenol A exposure and early childhood behavior[J]. Environ Health Perspect, 2009, 117(12):1945-1952. DOI: 10.1289/ehp.0900979.
[5]BraunJM, KalkbrennerAE, CalafatAM, et al. Impact of Early-Life Bisphenol A Exposure on Behavior and Executive Function in Children[J]. Pediatrics, 2011, 128(5): 873-882. DOI: 10.1542/peds.2011-1335.
[6]BraunJM, KalkbrennerAE, JustAC, et al. Gestational exposure to endocrine-disrupting chemicals and reciprocal social, repetitive, and stereotypic behaviors in 4-and 5-year-old children: the HOME study[J]. Environ Health Perspect, 2014, 122(5): 513-520. DOI: 10.1289/ehp.1307261.
[7]PereraF, VishnevetskyJ, HerbstmanJB, et al. Prenatal bisphenol A exposure and child behavior in an inner-city cohort[J]. Environ Health Perspect, 2012, 120(8): 1190-1194. DOI: 10.1289/ehp.1104492.
[8]RoenEL, WangY, CalafatAM, et al. Bisphenol A exposure and behavioral problems among inner city children at 7-9 years of age[J]. Environ Res, 2015, 142: 739-745. DOI: 10.1016/j.envres.2015.01.014.
[9]EvansSF, KobroslyRW, BarrettES, et al. Prenatal Bisphenol A Exposure and maternally reported behavior in boys and girls[J]. Neurotoxicology, 2014, 45: 91-99. DOI: 10.1016/j.neuro.2014.10.003.
[10]HarleyKG, Aguilar SchallR, ChevrierJ, et al. Prenatal and postnatal bisphenpl a exposure and body mass index in childhood in the CHAMACOS cohort[J]. Environ Health Perspect, 2013, 121(4): 514-520. DOI: 10.1289/ehp.1205548.
[11]TeppalaS, MadhavanS, ShankarA. Bisphenol A and Metabolic Syndrome: Results from NHANES[J]. Int J Endocrinol, 2012, 2012: 598180. DOI: 10.1155/2012/598180.
[12]LeeBE, ParkH, HongYC, et al. Prenatal bisphenol A and birth outcomes: MOCEH (Mothers and Children's Environmental Health) study[J]. Int J Hyg Environ Health, 2014, 217(2-3): 328-334. DOI: 10.1016/j.ijheh.2013.07.005.
[13]HuoW, XiaW, WanY, et al. Maternal urinary bisphenol A levels and infant low birth weight: A nested case-control study of the Health Baby Cohort in China[J]. Environ Int, 2015, 85: 96-103. DOI: 10.1016/j.envint.2015.09.005.
[14]SpanierAJ, KahnRS, KunselmanAR, et al. Bisphenol a exposure and the development of wheeze and lung function in children through age 5 years[J]. JAMA Pediatr, 2014, 168(12): 1131-1137. DOI: 10.1001/jamapediatrics.2014.1397.
[15]BraunJM, SathyanarayanaS, HauserR. Phthalate exposure and children's health[J]. Curr Opin Pediatr, 2013, 25(2): 247-254. DOI: 10.1097/MOP.0b013e32835e1eb6.
[16]EjaredarM, NyanzaEC, Ten EyckeK, et al. Phthalate exposure and childrens neurodevelopment: A systematic review[J]. Environ Res, 2015, 142: 51-60. DOI: 10.1016/j.envres.2015.06.014.
[17]Téllez-RojoMM, CantoralA, CantonwineDE, et al. Prenatal urinary phthalate metabolites levels and neurodevelopment in children at two and three years of age[J]. Sci Total Environ, 2013, 461-462: 386-390. DOI: 10.1016/j.scitotenv.2013.05.021.
[18]WhyattRM, LiuX, RauhVA, et al. Maternal prenatal urinary phthalate metabolite concentrations and child mental, psychomotor, and behavioral development at 3 years of age[J]. Environ Health Perspect, 2012, 120(2): 290-295. DOI: 10.1289/ehp.1103705.
[19]KobroslyRW, EvansS, MiodovnikA, et al. Prenatal phthalate exposures and neurobehavioral development scores in boys and girls at 6-10 years of age[J]. Environ Health Perspect, 2014, 122(5): 521-528. DOI: 10.1289/ehp.1307063.
[20]PolanskaK, LigockaD, SobalaW, et al. Phthalate exposure and child development: the Polish Mother and Child Cohort Study[J]. Early Hum Dev, 2014, 90(9): 477-485. DOI: 10.1016/j.earlhumdev.2014.06.006.
[21]TaylorCM, GoldingJ, EmondAM. Lead, cadmium and mercury levels in pregnancy: the need for international consensus on levels ofconcern[J]. J Dev Orig Health Dis, 2014, 5(1): 16-30. DOI: 10.1017/S2040174413000500.
[22]JohnstonJE, ValentinerE, MaxsonP, et al. Maternal cadmium levels during pregnancy associated with lower birth weight in infants in a North Carolina cohort[J]. PLoS One, 2014, 9(10): e109661. DOI: 10.1371/journal.pone.0109661.
[23]Al-SalehI, ShinwariN, MashhourA, et al. Birth outcome measures and maternal exposure to heavy metals (lead, cadmium and mercury) in Saudi Arabian population[J]. Int J Hyg Environ Health, 2014, 217(2-3): 205-218. DOI: 10.1016/j.ijheh.2013.04.009.
[24]RabitoFA, KocakM, WerthmannDW, et al. Changes in low levels of lead over the course of pregnancy and the association with birth outcomes[J]. Reprod Toxicol, 2014, 50: 138-144. DOI: 10.1016/j.reprotox.2014.10.006.
[25]PerkinsM, WrightRO, AmarasiriwardenaCJ, et al. Very low maternal lead level in pregnancy and birth outcomes in an eastern Massachusetts population[J]. Ann Epidemiol, 2014, 24(12): 915-919. DOI: 10.1016/j.annepidem.2014.09.007.
[26]RobertsAL, LyallK, HartJE, et al. Perinatal air pollutant exposures and autism spectrum disorder in the children of Nurses' Health Study II participants[J]. Environ Health Perspect, 2013, 121(8): 978-984. DOI: 10.1289/ehp.1206187.
[27]BoucherO, JacobsonSW, PlusquellecP, et al. Prenatal methylmercury, postnatal lead exposure, and evidence of attention deficit/hyperactivity disorder among Inuit children in Arctic Québec[J]. Environ Health Perspect, 2012, 120(10): 1456-1461. DOI: 10.1289/ehp.1204976.
[28]McDermottS, BaoW, Marjorie AelionC, et al. When are fetuses and young children most susceptible to soil metal concentrations of arsenic, lead and mercury?[J]. Spat Spatiotemporal Epidemiol, 2012, 3(3): 265-272. DOI: 10.1016/j.sste.2012.05.001.
[29]AdamsJB, AudhyaT, McDonough-MeansS, et al. Toxicological status of children with autism vs. neurotypical children and the association with autismseverity[J]. Biol Trace Elem Res, 2013, 151(2): 171-180. DOI: 10.1007/s12011-012-9551-1.
[30]FornsJ, FortM, CasasM, et al. Exposure to metals during pregnancy and neuropsychological development at the age of 4 years[J]. Neurotoxicology, 2014, 40: 16-22. DOI: 10.1016/j.neuro.2013.10.006.
[31]VanheesK, Vonh?genIG, van SchootenFJ, et al. You are what you eat, and so are your children: the impact of micronutrients on the epigenetic programming of offspring[J]. Cell Mol Life Sci, 2014, 71(2): 271-285. DOI: 10.1007/s00018-013-1427-9.
[32]DunnGA, BaleTL. Maternal high-fat diet promotes body length increases and insulin insensitivity in second-generation mice[J]. Endocrinology, 2009, 150(11): 4999-5009. DOI: 10.1210/en.2009-0500.
[33]GanteI, AmaralN, DoresJ, et al. Impact of gestational weight gain on obstetric and neonatal outcomes in obese diabetic women[J]. BMC Pregnancy Childbirth, 2015, 15: 249. DOI: 10.1186/s12884-015-0692-z.
[34]于冬梅,赵丽云,刘爱东,等.中国活产新生儿低出生体重发生率及影响因素[J].中华预防医学杂志,2007,41(z1):150-154.
[35]何修界,关美云,李李,等.婴儿母亲孕期增重对婴儿肥胖风险的影响[J].中华预防医学杂志,2013,47(3):245-248. DOI: 10.3760/cma.j.issn.0253-9624.2013.03.012.
[36]葛星,陶芳标.妇女孕前肥胖、孕期过度增重与儿童神经精神发育损伤[J].中华预防医学杂志,2014,48(7):644-646. DOI: 10.3760/cma.j.issn.0253-9624.2014.07.023.
[37]HoranMK, McGowanCA, GibneyER, et al. The association between maternal dietary micronutrient intake and neonatal anthropometry-secondary analysis from the ROLO study[J]. Nutr J, 2015, 14(1): 105. DOI: 10.1186/s12937-015-0095-z.
[38]AlwanNA, CadeJE, McArdleHJ, et al. Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study[J]. Br J Nutr, 2015, 113(12): 1985-1992. DOI: 10.1017/S0007114515001166.
[39]BeckhausAA, Garcia-MarcosL, FornoE, et al. Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: asystematic review and meta-analysis[J]. Allergy, 2015. DOI: 10.1111/all.12729.
[40]Pérez-LópezFR, PasupuletiV, Mezones-HolguinE, et al. Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials[J]. Fertil Steril, 2015, 103(5): 1278-1288.e4. DOI: 10.1016/j.fertnstert.2015.02.019.
[41]WeiSQ. Vitamin D and pregnancy outcomes[J]. Curr Opin Obstet Gynecol, 2014, 26(6): 438-447. DOI: 10.1097/GCO.0000000000000117.
[42]Centers for Disease Control and Prevention (US), National Center for Chronic Disease Prevention and Health Promotion (US), Office on Smoking and Health (US). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General[M]. Atlanta (GA): Centers for Disease Control and Prevention (US); 2010.
[43]GrzeskowiakLE, HodylNA, StarkMJ, et al. Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age[J]. J Dev Orig Health Dis, 2015, 6(6): 485-492. DOI: 10.1017/S2040174415007151.
[44]HuijbregtsSCJ, SéguinJR, ZelazoP, et al. Interrelations between maternal smoking during pregnancy, birth weight and sociodemographic factors in the prediction of early cognitive abilities[J]. Infant Child Dev, 2006, 15(6): 593-607. DOI: 10.1002/icd.480.
[45]PolanskaK, HankeW, SobalaW, et al. Developmental effects of exposures to environmental factors: The Polish Mother and Child Cohort Study[J]. Bio Med Res Int, 2013, 2013: 629716. DOI: 10.1155/2013/629716.
[46]MezzacappaE, BucknerJC, EarlsF. Prenatal cigarette exposure and infant learning stimulation as predictors of cognitive control in childhood[J]. Dev Sci, 2011, 14(4): 881-891. DOI: 10.1111/j.1467-7687.2011.01038.x.
[47]HsiehCHJ, LiaoHF, WuKY, et al. CYP1A1 Ile462Val and GSTT1 modify the effect of cord blood cotinine on neurodevelopment at 2 years of age[J]. Neurotoxicology, 2008, 29(5): 839-845. DOI: 10.1016/j.neuro.2008.05.006.
[48]LeeBE, HongYCH, ParkH, et al. Secondhand smoke exposure during pregnancy and infantile neurodevelopment[J]. Environ Res, 2011, 111(4): 539-544. DOI: 10.1016/j.envres.2011.02.014.
[49]SayalK, HeronJ, GoldingJ, et al. Prenatal alcohol exposure and gender differences in childhood mental health problems: A longitudinal population-based study[J]. Pediatrics, 2007, 119(2): e426-e434.
[50]WillfordJ, LeechS, DayN. Moderate prenatal alcohol exposure and cognitive status of children at age 10[J]. Alcohol Clin Exp Res, 2006, 30(6): 1051-1059. DOI: 10.1111/j.1530-0277.2006.00119.x.
[51]KesmodelUS, BertrandJ, St?vringH, et al. The effect of different alcohol drinking patterns in early to mid-pregnancy on the child's intelligence, attention, and executive function[J]. BJOG, 2012, 119(10): 1180-1190. DOI: 10.1111/j.1471-0528.2012.03393.x.
[52]LesterBM, ConradtE, MarsitCJ. Epigenetic basis for the development of depression in children[J]. Clin Obstet Gynecol, 2013, 56(3): 556-565. DOI: 10.1097/GRF.0b013e318299d2a8.
[53]GudsnukK, ChampagneFA. Epigenetic influence of stress and the social environment[J]. ILAR J, 2012, 53(3-4): 279-288. DOI: 10.1093/ilar.53.3-4.279.
[54]MulliganCJ, D'ErricoNC, SteesJ, et al. Methylation changes at NR3C1 in newborns associate with maternal prenatal stress exposure and newborn birth weight[J]. Epigenetics, 2012, 7(8): 853-857. DOI: 10.4161/epi.21180.
[55]OberlanderTF, WeinbergJ, PapsdorfM, et al. Prenatal exposure to maternal depression, neonatal methylation of human glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses[J]. Epigenetics, 2008, 3(2): 97-106. DOI: 10.4161/epi.3.2.6034.
[56]HompesT, IzziB, GellensE, et al. Investigating the influence of maternal cortisol and emotional state during pregnancy on the DNA methylation status of the glucocorticoid receptor gene (NR3C1) promoter region in cord blood[J]. J Psychiatr Res, 2013, 47(7): 880-891. DOI: 10.1016/j.jpsychires.2013.03.009.
[57]BoersmaGJ, LeeRS, CordnerZA, et al. Prenatal stress decreases BDNF expression and increases methylation of BDNF exon IV in rats[J]. Epigenetics, 2014, 9(3): 437-447. DOI: 10.4161/epi.27558.
[58]Van den HoveDL, KenisG, BrassA, et al. Vulnerability versus resilience to prenatal stress in male and female rats; implications from gene expression profiles in the hippocampus and frontal cortex[J]. Eur Neuropsychopharmacol, 2013, 23(10): 1226-1246. DOI: 10.1016/j.euroneuro.2012.09.011.
[59]DesrosiersTA, LawsonCC, MeyerRE, et al. Maternal occupational exposure to organic solvents during early pregnancy and risks of neural tube defects and orofacial clefts[J]. Occup Environ Med, 2012, 69(7): 493-499. DOI: 10.1136/oemed-2011-100245.
[60]Infante-RivardC, DeadmanJE. Maternal occupational exposure to extremely low frequency magnetic fields during pregnancy and childhood leukemia[J]. Epidemiology, 2003, 14(4): 437-441.
[61]TannerJP, SalemiJL, StuartAL, et al. Associations between exposure to ambient benzene and PM2.5 during pregnancy and the risk of selected birth defects in offspring[J]. Environ Res, 2015, 142: 345-353. DOI: 10.1016/j.envres.2015.07.006.
[62]DeFrancoE, HallE, HossainM, et al. Air pollution and stillbirth risk: exposure to airborne particulate matter during pregnancy is associated with fetal death[J]. PLoS One, 2015, 10(3): e0120594. DOI: 10.1371/journal.pone.0120594.
[63]XuZ, SheffieldPE, SuH, et al. The impact of heat waves on children's health: a systematic review[J]. Int J Biometeorol, 2014, 58(2): 239-247. DOI: 10.1007/s00484-013-0655-x.
[64]PoursafaP, KeikhaM, KelishadiR. Systematic review on adverse birth outcomes of climate change[J]. J Res Med Sci, 2015, 20(4): 397-402.

用户评论 0条

用户名: 密码: 登陆 注册
 
  • 9
  • 3
  •  4 : 页次:0/0页 共0条记录 5条/每页
    关于我们 | 专家风采 | 会员注册 | 继续教育
    地 址:北京市西城区东河沿街69号正弘大厦511室 邮 编:100052
    电话:010-51322302
    版权所有 中华医学会及中华预防医学杂志编辑部
    京ICP备 07035254 号