马鞍山出生队列（MABC）研究

Cohort profile: The Ma’anshan birth cohort (MABC) study

队列概况：马鞍山出生队列（MABC）研究

Author: Kun Huang, Juan Tong, Shuman Tao, Xiaoyan Wu, Shuangqin Yan, Guopeng Gao, Hui Cao, Liangliang Xie, Hui Gao, Menglong Geng, Chunmei Liang, Hong Gan, Yan Han, Mengjuan Lu, Yuzhu Teng, Shilu Tong, Fangbiao Tao

Source: International Journal of Epidemiology

DOI: 10.1093/ije/dyae142

Absaract

Purpose: In this paper, the implementation framework and steps of MABC are introduced in detail, reflecting the important achievements of the laboratory in leading the construction of prospective birth cohort, and committed to population health promotion and birth defect prevention and control research in recent years.

Methods: MABC recruited 3,474 women in the first trimester of pregnancy within 14 weeks of pregnancy and systematically evaluated the relationship between exposure to environmental pollutants (environmental endocrine disruptors, heavy metals, antibiotics, etc.) , prenatal psychosocial stress, prenatal endocrine and metabolic factors and fetal and infant development. The children's physical, behavioral, emotional, cognitive and other developmental levels were evaluated comprehensively. The cohort was followed up 20 times during the first trimester, second trimester, third trimester, delivery, 42 days, 3 months, 6 months, 9 months, 12 months, 1 1/2 years, 2 years, 2 1/2 years, 3 years, 3 and a half years, 4 years, 4 and a half years, 5 years, 5 and a half years, 6 years, 7 years. Follow-up of children aged 7 to 8 years, 9 to 10 years, 11 to 12 years and 13 to 14 years will continue in the later stage, which is one of the two birth cohorts with the highest follow-up density in the world.

Results: The high frequency of follow-up helps to obtain continuous and dynamic data on maternal and infant environmental exposure, revealing the trajectory of environmental exposure and its potential impact on child development. We found that prenatal exposure to phthalate metabolites, metal and metalloidan, and antibiotics is associated with increased health risks of maternal and children. For example, prenatal phthalate exposure increased the risk of maternal anaemia, excessive weight gain, gestational diabetes mellitus(GDM), HDP, intrahepatic cholestasis, and LBW, and was associated with preterm birth and offspring’s intellectual developmental abnormalities. Meanwhile, Maternal exposure to arsenic or thallium had a potential adverse effect on GDM and neurodevelopment in children.We also found that antibiotic exposure during pregnancy was associated with an elevated risk of of eczema and asthma in children and maternal thyroid function interference.

Conclusion: MABC has collected valuable data on environmental pollutants based on repeated measurements, systematically elucidates the potential impact of multiple types of exposure in early life on maternal and child health, and provides an important epidemiological basis for the development of maternal and child environmental monitoring and health care guidelines during pregnancy.

摘要

目的：本文详细介绍了MABC实施框架和步骤，反映了近年来实验室在引领前瞻性出生队列建设、致力于人口健康促进与出生缺陷防控研究的重要成果体现。

方法：MABC招募了3474名孕14周内的孕早期妇女，系统评价了孕早期、孕中期、孕晚期环境污染物暴露（环境内分泌干扰物、重金属、抗生素等），孕期心理社会应激，孕期内分泌代谢因素与胎婴儿发育的关联，并对儿童体格、行为、情绪、认知等多种发育水平开展综合评估。队列在孕妇孕早期、孕中期、孕晚期、分娩期、儿童42天、3个月、6个月、9个月、12个月、1岁半、2岁、2岁半、3岁、3岁半、4岁、4岁半、5岁、5岁半、6岁、7岁共随访了20次，后期将继续展开儿童7～8岁、9～10岁、11～12岁和13～14岁随访，是目前全球两个随访密度最大的出生队列之一。

结果：高频率随访有助于获得母婴环境暴露的连续动态数据，揭示环境暴露轨迹及其对儿童发育的潜在影响。我们发现，产前接触邻苯二甲酸酯代谢物、金属和金属单质以及抗生素与孕产妇和儿童健康风险增加有关。例如，产前邻苯二甲酸盐暴露增加了产妇贫血、体重过度增加、妊娠糖尿病等的风险，并与早产和后代智力发育异常有关。同时，母亲暴露砷或铊对妊娠糖尿病和儿童神经发育有潜在的不利影响。我们还发现，怀孕期间接触抗生素与儿童患湿疹和哮喘风险的增加以及母亲甲状腺功能受到干扰有关。

结论：MABC收集了宝贵的基于重复测量的环境污染物数据，系统阐述了生命早期多类型暴露对母婴健康的潜在影响，为制定孕期母婴环境监测和医疗保健指南提供了重要的流行病学依据。