孕期双酚A暴露对学龄前儿童情绪和行为问题的影响

Exposure to bisphenol A during maternal pregnancy and the emotional and behavioral impact on their preschool children

目的探讨孕期双酚A（BPA）暴露对学龄前儿童情绪和行为问题的远期影响效应。方法研究样本源于中国安徽出生队列研究（China-Anhui Birth Cohort Study）的前瞻性随访人群。采用课题组编制的调查表收集孕妇和儿童的基本信息，运用固相萃取-同位素内标-高效液相色谱串联质谱法检测母亲孕期血清中游离的BPA含量。应用长处和困难问卷评估学龄前儿童的情绪和行为问题，最终纳入1713对母子。运用多分类logistic回归模型分析孕期BPA暴露与学龄前儿童情绪和行为问题的病因关联。结果1713名学龄前儿童中，情绪症状异常检出率为6．48％，品行问题异常检出率为8．11％，多动／注意缺陷异常检出率为8．35％，同伴交往异常检出率为2．86％，亲社会行为问题异常检出率为11．38％，困难总分异常检出率为7．94％。按血清游离BPA浓度（ng／ml）分位数法将研究对象分为低暴露组（≤0．120）、中暴露组（0．120〈BPA〈0．400）和高暴露组（≥0．400），母亲孕期高水平BPA暴露是学龄前儿童品行问题异常的危险因素（OR=1．876，95％CI：1．161—3．029），且在男童中表现更明显（OR=2．291，95％CI：1．126～4．661）。结论母亲孕期高水平BPA暴露可能增加学龄前儿童品行问题异常的发生风险，且在男童中表现得更为明显。

Objective To explore the long-term effects of maternal pregnancy bisphenol A （BPA） exposure on emotional and behavioral problems appeared in their preschool children. Methods The study sample was a subset of the China-Anhui Birth Cohort Study （C-ABCS）. A unified questionnaire was used to collect basic information on both pregnant women and their children. Free BPA concentration in maternal serum was determined by high-performance liquid chromatographytandem mass spectrometry （HPLC-MS/MS）. The parent-report version of the Strengths and Difficulties Questionnaire （SDQ） was used to estimate the emotional and behavioral problems in preschool children. A total of 1 713 pairs of mothers and children were included in this study. Association between BPA exposure during pregnancy and the emotional and behavioral problems in preschool children was evaluated with multinomial logistic regression model. Results Prevalence rates in 1 713 preschool children appeared as： 6.48% of emotional problems, 8.11% for conduct problems,8.35% for hyperactivity/ inattention, 2.86% for peer problems, 11.38% for prosocial behaviors and 7.94% for total difficulties. Subjects were divided according to the degrees of exposure and the results showed as： low exposure group （≤0.120 ng/ml）, medium exposure group （0.120〈BPA〈0.400 ng/ ml） and high exposure group （≥0.400 ng/ml） according to the serum BPA concentration in tertile. Results from the multivariate logistic regression analysis showed that high level of maternal BPA exposure appeared a risk factor on children＇s abnormal conducts （OR=1.876, 95%CI： 1.161-3.029）, more obvious in boys （OR=2.291, 95% CI： 1.126-4.661）. Conclusion Maternal exposure to high level of BPA during pregnancy might increase the detrimental effects of abnormal conducts in their preschool children, more obviously seen in boys.