在一项前瞻性队列研究中，怀孕期间接触颗粒物质与幼儿执行功能之间的关系

Associations between particulate matter exposure during pregnancy and executive function of toddlers in a prospective cohort study

在一项前瞻性队列研究中，怀孕期间接触颗粒物质与幼儿执行功能之间的关系

Authors: Lei Zhang, Yuanyuan Zhu, Haixia Wang, Ping Zu, Wei Luo, Yunlong Chen, Chenxi Zhou, Fangbiao Tao, Peng Zhu

Source： Environmental research Volume 258, 1 October 2024, 119463

Background: Exposure to particulate matter (PM) has been found to be associated with impaired cognitive function. However, limited evidence is available on the relationship between PM exposure in the prenatal period and toddler executive function (EF), and the potential influence of breastfeeding.

Methods: The study included 1106 mother-toddler pairs recruited between 2015 and 2019. We assessed mothers’ PM1, PM2.5, and PM10 prenatal exposure with a satellite-based dataset at a 1 × 1 km spatial resolution and assigned to participants based on residential addresses. Toddler EF was measured using the Behavior Rating Inventory of Executive Function for Preschoolers (BRIEF-P) questionnaire, higher BRIEF-P scores indicated poorer EF in toddlers. We determined the associations of PM exposure during pregnancy with BRIEF-P scores using multiple linear regression models.

Results: In the first trimester, a 10 μg/m3 increase of PM was associated with 1.49 (95% confidence interval [CI]: 0.14–2.83; PM1), 0.68 (95% CI: 0.10–1.26; PM2.5), and 0.63 (95% CI: 0.07–1.20; PM10) elevated toddler global executive composite index scores, respectively. In the stratified analysis, a 10 µg/m3 increase in first trimester PM1 exposure was related to 0.54 (95% CI: 0.19–0.89) higher inhibition scores in toddlers who received complementary breastfeeding for less than six months and -0.15 (95% CI: -0.81–0.51) higher inhibition scores in toddlers who received complementary breastfeeding for six months or more (P for interaction: 0.046). Additionally, a 10 µg/m3 increment in first trimester PM1 exposure was related to 0.36 (95% CI: 0.13–0.59) higher emotional control scores in toddlers who received breastfeeding for less than 12 months and -0.54 (95% CI: -1.25–0.18) higher inhibition scores in toddlers who received breastfeeding for no less than 12 months (P for interaction: 0.043).

Conclusions: PM exposure during the first trimester, especially PM1, has been linked to lower toddler EF performance in toddlers; feeding with breast milk may be a potential protective measure.

背景：已发现接触颗粒物 (PM) 与认知功能受损有关。然而，关于产前 PM 暴露与幼儿执行功能 (EF) 之间的关系以及母乳喂养的潜在影响的证据有限。

方法：本研究包括 2015 年至 2019 年期间招募的 1106 对母婴对。我们使用 1 × 1 公里空间分辨率的卫星数据集评估了母亲的 PM1、PM2.5 和 PM10 产前暴露情况，并根据居住地址分配给参与者。使用学龄前儿童执行功能行为评定量表 (BRIEF-P) 问卷测量幼儿 EF，BRIEF-P 分数越高，幼儿 EF 越差。我们使用多元线性回归模型确定了怀孕期间 PM 暴露与 BRIEF-P 分数的关联。

结果：在妊娠前三个月，PM1 浓度每增加10 μg/m3，幼儿整体执行综合指数得分分别升高1.49（95% 置信区间[CI]：0.14–2.83；PM1）、0.68（95% CI：0.10–1.26；PM2.5）和 0.63（95% CI：0.07–1.20；PM10）。在分层分析中，妊娠前三个月 PM1 暴露浓度每增加 10 μg/m3，接受辅食喂养时间少于六个月的幼儿的抑制得分增加 0.54（95% CI：0.19–0.89），接受辅食喂养时间六个月或以上的幼儿的抑制得分增加 -0.15（95% CI：-0.81–0.51）（交互作用P值：0.046）。此外，妊娠前三个月 PM1 暴露水平每增加 10 μg/m3，母乳喂养时间少于 12 个月的幼儿情绪控制得分将提高 0.36（95% CI：0.13–0.59），母乳喂养时间不少于 12 个月的幼儿抑制得分将提高 -0.54（95% CI：-1.25–0.18）（交互作用P值：0.043）。

结论：妊娠前三个月的 PM 暴露，尤其是 PM1，与幼儿 EF 表现较低有关；母乳喂养可能是一种潜在的保护措施。