孕期多环芳烃暴露与幼儿孤独症谱系障碍相关行为关系的出生队列研究

Association of exposure to polycyclic aromatic hydrocarbons during pregnancy with autism spectrum disorder-related behaviors in toddlers: a birth cohort study

摘要:

目的 探讨母孕期多环芳烃（PAHs）暴露与幼儿孤独症谱系障碍（ASD）相关行为的相关性。方法 采用出生队列研究，选择已进行脐带血PAH-DNA加合物测定并完成36月龄幼儿行为问题评估的348名幼儿作为研究对象。采用2~3岁儿童行为量表（CBCL）、孤独症行为评定量表（ABC）评定36月龄幼儿行为问题。分析脐带血PAH-DNA加合物浓度与36月龄幼儿CBCL量表、ABC量表得分间的相关性。结果 新生儿脐带血PAH-DNA加合物的检出率为52.3%，浓度中位数为0.68 ng/mL。CBCL量表总得分中位数为23分，ABC量表总得分中位数为8分。PAH-DNA加合物浓度与36月龄幼儿CBCL量表中社交退缩得分呈正相关（r_s=0.205，P < 0.05），与ABC量表总分、生活自理能力得分呈正相关（分别r_s=0.412、0.355，均P < 0.05）。PAH-DNA加合物浓度与36月龄幼儿ABC量表总分密切相关（β=0.122，P < 0.05）。结论 母孕期PAHs暴露是儿童发生ASD相关行为的危险因素。有效降低母孕期PAHs暴露，开展新生儿脐带血PAH-DNA加合物检测，对ASD的早期预防、筛查及干预工作具有重要意义。

Abstract:

Objective To study the association of exposure to polycyclic aromatic hydrocarbons (PAH) during pregnancy and autism spectrum disorder (ASD)-related behaviors in toddlers. Methods A total of 348 toddlers who had accepted the measurement of PAH-DNA adduct in umbilical cord blood and evaluation of behavior problems at the age of 36 months were enrolled in this birth cohort study. Child Behavior Checklist (CBCL) and Autism Behavior Checklist (ABC) were used to evaluate behavior problems at the age of 36 months. The correlation of the concentration of PAH-DNA adduct in umbilical cord blood with CBCL and ABC scores at the age of 36 months were analyzed. Results The detection rate of PAH-DNA adduct in umbilical cord blood was 52.3%, and the median concentration was 0.68 ng/mL. The median total scores of CBCL and ABC scales were 23 and 8 respectively. In children aged 36 months, the concentration of PAH-DNA adduct was positively correlated with the score of social withdrawal in the CBCL scale (r_s=0.205, P < 0.05), the total score of the ABC scale (r_s=0.412, P < 0.05), and the selfcare score of the ABC scale (r_s=0.355, P < 0.05). The concentration of PAH-DNA adduct was closely associated with the total score of the ABC scale in children aged 36 months (β=0.122, P < 0.05). Conclusions PAH exposure during pregnancy may be a risk factor for ASD-related behaviors in toddlers. Effective reduction of PAH exposure during pregnancy and detection of PAH-DNA adduct in neonatal umbilical cord blood are of vital importance for early prevention, screening and intervention of ASD.