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农村妇女孕期环境烟草烟雾暴露对婴儿神经心理发育影响队列研究

Effects of maternal environmental tobacco smoke exposure during pregnancy on neurodevelopment of one-year-old rural infants in Yunnan province: a cohort study

    摘要
  • 摘要:
    目的 探讨农村妇女孕期环境烟草烟雾（ETS）暴露对1岁婴儿神经心理发育的影响。
    方法 基于前期云南宣威农村地区建立的出生队列，于2018年1月 — 2019年12月招募活产儿385人，随访至1岁。采用超高效液相色谱 – 串联质谱法测定前期队列收集的妇女孕早期、孕中期、孕晚期尿液样本中可替宁（UC）浓度，评估妇女孕期ETS暴露情况；采用贝利婴幼儿发育量表（BSID-III）评估婴儿的神经心理发育水平；构建多重线性回归以及logistic回归模型分析孕期ETS暴露对婴儿神经心理发育的影响。
    结果 385名农村妇女孕早、中、晚期UC平均水平M（P25～P75）分别为2.94（0.66～6.28）、2.86（0.58～5.85）、2.50（0.39～5.78）ng/mL；ETS暴露率分别为80.26%、81.04%、80.00%。1岁婴儿神经心理发育各维度得分分别为认知（99.17 ± 17.57）分、语言（93.46 ± 15.44）分、运动（93.66 ± 15.83）分、社会情感（109.03 ± 22.36）分、适应性行为（87.83 ± 15.67）分，这5个维度发育落后率分别为9.35%、22.60%、18.44%、6.49%和29.35%。多重线性回归模型结果显示，孕早期ETS暴露与1岁婴儿的运动得分呈负相关（β = – 0.239，95%CI = – 0.454～ – 0.025）。logistic回归分析结果显示，孕早期ETS暴露可使1岁婴儿语言发育落后的风险增加（OR = 3.497，95%CI = 1.186～10.309）。
    结论 妇女孕早期ETS暴露可能影响婴儿的神经心理发育水平，主要是运动和语言发育。

     

    Abstract:
    Objective To study the effect of maternal environmental tobacco smoke (ETS) exposure during pregnancy on the neurodevelopment of one-year-old rural infants in Yunnan province.
    Methods A total of 385 newborns born between 2018 and 2019 in rural Xuanwei, Yunnan province, were recruited into a cohort and followed until 1 year of age. Ultra-high performance liquid chromatography-tandem mass spectrometry was used to determine urinary cotinine (UC) concentrations in samples collected from the mothers of the newborns in early, mid, and late pregnancy to assess maternal ETS exposure during pregnancy. The Bayley Scales of Infant and Toddler Development – Third Edition (BSID-III) was used to assess infant neurodevelopment. Multiple linear regression and logistic regression models were constructed to analyze the effect of ETS exposure during pregnancy on infant neurodevelopment.
    Results The mean UC levels (median 25th percentile, 75th percentile ng/mL) of the 385 mothers in early, mid, and late pregnancy were 2.94 (0.66, 6.28), 2.86 (0.58, 5.85), and 2.50 (0.39, 5.78), respectively, and ETS exposure in early, mid, and late pregnancy was reported by 80.26%, 81.04%, and 80.00% of the mothers, respectively. For the infants at 1 year of age, the BSID-III dimensional development scores were 99.17 ± 17.57 for cognition, 93.46 ± 15.44 for language, 93.66 ± 15.83 for motor, 109.03 ± 22.36 for social-emotional, and 87.83 ± 15.67 for adaptive behavior, with 9.35%, 22.60%, 18.44%, 6.49%, and 29.35% of the infants assessed having scores indicating delayed five-dimensional development. The results of the multiple linear regression analysis showed that maternal ETS exposure in early pregnancy was negatively correlated with BSID-III motor score in 1-year-old infants (β = – 0.239, 95% confidence interval 95%CI: – 0.454, – 0.025). The results of logistic regression analysis showed that maternal ETS exposure in early pregnancy may increase the risk of delayed language development in 1-year-old infants (odds ratio = 3.497, 95%CI: 1.186, 10.309).
    Conclusion Maternal ETS exposure during early pregnancy may affect infant neurodevelopment one year after birth, particularly motor and language development.

     

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