胎兒在母體中曝露organophosphate 和ADHD有相關性
測兩次母血的DAP level和將來小朋友的觀察分數有相關
但是證據尚嫌薄弱
和之前http://pediatrics.jwatch.org/cgi/content/full/2010/602/1
的那篇文章倒是有點相關。但ADHD是不是被過分誇大了呢?
Is Prenatal Exposure to Organophosphate Pesticides Associated with Attention-Deficit/Hyperactivity Disorder?
Maternal prenatal pesticide levels were associated with attention problems in 5-year-old boys.
Organophosphate pesticides inhibit acetylcholinesterase activity and thereby increase levels of acetylcholine in the central nervous system. Recent studies suggest that fetal exposure to organophosphates is associated with abnormal neonatal reflexes and poorer performance on infant mental development scales. To explore this association further, investigators measured dialkyl phosphate (DAP) metabolites of organophosphate pesticides in maternal urine at two time points during pregnancy in 348 Mexican American women (mean age, 26) who delivered healthy newborns in a California agricultural community. Attention was measured by maternal report (Child Behavior Checklist), direct assessment, and psychometricians' reports of the children's behavior during testing.
Prenatal DAP levels were not significantly associated with maternal report of attention problems or children's visual attention test scores at age 3.5 years. However, prenatal DAP levels were significantly associated with maternal reports of attention problems and scores on a clinical attention-deficit/hyperactivity disorder (ADHD) confidence index (the Conners' Kiddie Continuous Performance Test) at age 5 years, but not with scores on a behavior rating scale (Hillside Behavior Rating Scale). Prenatal DAP was also associated with a composite indicator of ADHD (based on the 3 measures) at age 5 years. The associations were most robust in 5-year-old boys. Children's DAP metabolite levels at ages 3.5 and 5 years were not associated with attention outcomes.
Comment: Similar to other behavioral conditions, ADHD reflects an interaction between biological predisposition and the environment. Environmental risks include inappropriate teacher and parent expectations as well as their responses to core ADHD behaviors. A recent study concluded that prenatal tobacco and childhood lead exposures are associated with ADHD (Pediatrics 2009; 124:e1054). The current study suggests that an in utero environmental toxin that might affect fetal brain development is another risk factor for ADHD. A cautionary note: The documentation of an attention problem is not sufficient for a diagnosis of ADHD. Teacher reports about classroom behavior and impairment in learning or social development are important components that were not included in this study.
— Martin T. Stein, MD
Published in Journal Watch Pediatrics and Adolescent Medicine September 15, 2010
Citation(s):
Marks AR et al. Organophosphate pesticide exposure and attention in young Mexican-American children. Environ Health Perspect 2010 Aug 19; [e-pub ahead of print]. (http://dx.doi.org/10.1289/ehp.1002056)
但是證據尚嫌薄弱
和之前http://pediatrics.jwatch.org/cgi/content/full/2010/602/1
的那篇文章倒是有點相關。但ADHD是不是被過分誇大了呢?
Is Prenatal Exposure to Organophosphate Pesticides Associated with Attention-Deficit/Hyperactivity Disorder?
Maternal prenatal pesticide levels were associated with attention problems in 5-year-old boys.
Organophosphate pesticides inhibit acetylcholinesterase activity and thereby increase levels of acetylcholine in the central nervous system. Recent studies suggest that fetal exposure to organophosphates is associated with abnormal neonatal reflexes and poorer performance on infant mental development scales. To explore this association further, investigators measured dialkyl phosphate (DAP) metabolites of organophosphate pesticides in maternal urine at two time points during pregnancy in 348 Mexican American women (mean age, 26) who delivered healthy newborns in a California agricultural community. Attention was measured by maternal report (Child Behavior Checklist), direct assessment, and psychometricians' reports of the children's behavior during testing.
Prenatal DAP levels were not significantly associated with maternal report of attention problems or children's visual attention test scores at age 3.5 years. However, prenatal DAP levels were significantly associated with maternal reports of attention problems and scores on a clinical attention-deficit/hyperactivity disorder (ADHD) confidence index (the Conners' Kiddie Continuous Performance Test) at age 5 years, but not with scores on a behavior rating scale (Hillside Behavior Rating Scale). Prenatal DAP was also associated with a composite indicator of ADHD (based on the 3 measures) at age 5 years. The associations were most robust in 5-year-old boys. Children's DAP metabolite levels at ages 3.5 and 5 years were not associated with attention outcomes.
Comment: Similar to other behavioral conditions, ADHD reflects an interaction between biological predisposition and the environment. Environmental risks include inappropriate teacher and parent expectations as well as their responses to core ADHD behaviors. A recent study concluded that prenatal tobacco and childhood lead exposures are associated with ADHD (Pediatrics 2009; 124:e1054). The current study suggests that an in utero environmental toxin that might affect fetal brain development is another risk factor for ADHD. A cautionary note: The documentation of an attention problem is not sufficient for a diagnosis of ADHD. Teacher reports about classroom behavior and impairment in learning or social development are important components that were not included in this study.
— Martin T. Stein, MD
Published in Journal Watch Pediatrics and Adolescent Medicine September 15, 2010
Citation(s):
Marks AR et al. Organophosphate pesticide exposure and attention in young Mexican-American children. Environ Health Perspect 2010 Aug 19; [e-pub ahead of print]. (http://dx.doi.org/10.1289/ehp.1002056)
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