叶酸和维生素D在产前邻苯二甲酸酯暴露与学龄前儿童情绪和行为问题关系中的调节作用

Modulation effects of folic acid and vitamin D on the relationships between prenatal cumulative phthalate exposure and preschoolers' emotional and behavioral problems

叶酸和维生素D在产前邻苯二甲酸酯暴露与学龄前儿童情绪和行为问题关系中的调节作用

Authors: Li-Wen Chen , Xin Chen , Chen Han , Bei-Bei Zhu , Yi-Fan Wang , Yuan Liu , Min-Min Jiang , Ya-Fei Wang , Chun-Han Shan , Hua-Yan Mo , Kun Huang , Hui Gao , Fang-Biao Tao

Source：Environ Int.  

DOI: 10.1016/j.envint.2025.109284. 

Abstract

Background: The results of current population-based studies exploring the effects of prenatal phthalate exposure on children's behavioral problems are not completely consistent. In addition, it is not clear whether vitamins improve phthalate-induced health risks.

Methods:This study was based on the Ma'anshan Birth Cohort, which included 2910 mother-child pairs. To assess children's behavior, we used the Strengths and Difficulties Questionnaire (SDQ). A latent category growth model was used to model the scores of each subscale of the SDQ. Quantile g-computation and Bayesian kernel machine regression were applied to analyze the effect of prenatal cumulative phthalate exposure.

Results: Prenatal cumulative phthalate exposure was associated with the "borderline and abnormal emotional symptoms" trajectory (β = 0.146, 95 % CI = -0.0003, 0.292), affecting girls more in emotional areas, and boys in conduct areas. There was an interaction effect between folic acid supplementation, vitamin D levels and phthalate mixtures on the risk of abnormal emotional behavior in children, which was reflected mainly in prosocial behavior and conduct problems.

Conclusions: Prenatal cumulative phthalate exposure increased the risk of abnormal emotional symptoms in children, and there were sex differences. The duration of folic acid supplementation and vitamin D level can affect the effects of cumulative phthalate exposure on emotion and behavior.

Keywords: Behavior; Emotion; Phthalate; Prenatal exposure; Strengths and Difficulties Questionnaire.

摘要

背景： 目前探索产前邻苯二甲酸酯暴露对儿童行为问题影响的基于人群的研究结果并不完全一致。此外，目前尚不清楚维生素是否能改善邻苯二甲酸酯引起的健康风险。

方法： 本研究基于马鞍山出生队列，包括 2910 对母子。为了评估儿童的行为，我们使用了优势和困难问卷 （the Strengths and Difficulties Questionnaire，SDQ）。使用潜在类别增长模型对 SDQ 的每个子量表的分数进行建模。应用分位数 g 计算和贝叶斯核机回归分析产前累积邻苯二甲酸酯暴露的影响。

结果： 产前累积邻苯二甲酸酯暴露与 “边缘和异常情绪症状” 轨迹相关 （β = 0.146,95 % CI = -0.0003,0.292），在情绪领域对女孩的影响更大，在行为领域对男孩的影响更大。叶酸补充剂、维生素 D 水平和邻苯二甲酸酯混合物对儿童异常情绪行为风险存在交互作用，主要体现在亲社会行为和行为问题上。

结论： 产前累积邻苯二甲酸酯暴露增加了儿童异常情绪症状的风险，且存在性别差异。叶酸补充剂的持续时间和维生素 D 水平会影响累积邻苯二甲酸酯暴露对情绪和行为的影响。

关键词： 行为；情感；邻苯二甲酸盐；产前暴露；优势和困难问卷。