Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study

BACKGROUND@#Congenital heart disease (CHD) is one of the most common congenital malformations in humans. Inconsistent results emerged in the existed studies on associations between air pollution and congenital heart disease. The purpose of this study was to evaluate the association of gestational exposure to air pollutants with congenital heart disease, and to explore the critical exposure windows for congenital heart disease.@*METHODS@#The nested case-control study collected birth records and the following health data in Tianjin Women and Children's Health Center, China. All of the cases of congenital heart disease from 2013 to 2015 were selected matching five healthy controls for each case. Inverse distance weighting was used to estimate individual exposure based on daily air pollution data. Furthermore, the conditional logistic regression with distributed lag non-linear model was performed to identify the association between gestational exposure to air pollution and congenital heart disease.@*RESULTS@#A total of 8,748 mother-infant pairs were entered into the analysis, of which 1,458 infants suffered from congenital heart disease. For each 10 µg/m3 increase of gestational exposure to PM2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001-1.016) to 1.013 (1.001-1.024) during the 1st-2nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O3 exposure during the 1st week and SO2 exposure during 6th-7th weeks in the first trimester, while no significant findings for other air pollutants.@*CONCLUSIONS@#This study highlighted that gestational exposure to PM2.5, O3, and SO2 had lag effects on congenital heart disease. Our results support potential benefits for pregnancy women to the mitigation of air pollution exposure in the early stage, especially when a critical exposure time window of air pollutants may precede heart development.

Correlation analysis between prenatal exposure of per-/polyfluoroalkyl compounds and neonatal outcome / 中华预防医学杂志

Objective: To investigate the correlation between the prenatal exposure of per-/polyfluoroalkyl substances (PFASs) and the neonatal outcome. Methods: A total of 506 maternal infant cohort samples were collected in Hangzhou, Zhejiang province from 2020 to 2021. The exposure levels of seven PFASs in maternal serum before delivery were detected by solid-phase extraction-ultra performance liquid chromatography tandem mass spectrometry. Multivariable linear regression model was used to analyze the influence of prenatal exposure of PFASs on birth weight, birth length and Apgar score. Results: The maternal age, prenatal body mass index and gestation age were (31.3±4.3) years old, (26.7±3.2) kg/m2 and (265.0±28.3) days, respectively. The birth weight, birth length and scores of Apgar-1 and Apgar-5 were (3.1±0.8) kg, (49.3±2.9) cm, (9.88±0.47) points and (9.99±0.13) points, respectively. PFASs were widely distributed in maternal serum, with the highest concentration of (18.453±19.557) ng/ml, (6.756±9.379) ng/ml and (5.057±8.555) ng/ml for perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS) and 6∶2 chlorinated polyfluorinated ether sulfonate (Cl-PFESA), respectively. Maternal age, parity and delivery mode were associated with the exposure level of PFASs (P<0.05). Subgroup analysis showed that PFOS had negative effects on birth weight (β=-0.958), birth length (β=-0.073) and Apgar-5 score (β=-0.288) for neonates in the low birth weight (LBW) group. 6∶2 Cl-PFESA and 8∶2 Cl-PFESA inhibited the birth weight (β=-0.926; β=-0.552) and length (β=-0.074; β=-0.045) of newborn in the LBW group. In addition, 4∶2 fluorotelomer sulfonate (FTS) was associated with increased birth weight (β=0.111) and decreased Apgar-5 score (β=-0.030) in the normal weight group. Conclusion: Prenatal exposure to PFASs is associated with birth weight, birth length and Apgar-5 score. It is necessary to continue to pay attention to the impact of PFASs on fetal growth and development through maternal-fetal transmission.

Research progress on the relationship between air pollution and gestational diabetes / 中华预防医学杂志

Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications and has serious implications for the health of mothers and their offspring. In recent years, studies have confirmed that air pollution is one of the main risk factors for diabetes, and there is increasing evidence that air pollution exposure is closely related to the occurrence of gestational diabetes. However, current studies on the association between air pollutant exposure and the incidence of gestational diabetes are inconsistent, and the window period of pollutant exposure is still unclear. Limited mechanistic studies suggest that airborne particulate matter and gaseous pollutants may affect GDM through multiple mechanisms, including inflammation, oxidative stress, disruption of adipokine secretion, and imbalance of intestinal flora. This review summarizes the relationship between air pollutant exposure and the incidence of GDM in recent years, as well as the possible molecular mechanism of the occurrence and development of GDM caused by air pollutants, in order to provide scientific basis for preventing pollutant exposure, reducing the risk of GDM, improving maternal and fetal outcomes and improving the quality of the birth population.

Exposição aos agrotóxicos em cidade de intensa atividade do agronegócio e desfechos gestacionais adversos / Exposure to pesticides in a city with intense agribusinessactivity and adverse gestational outcomes / Exposición a plaguicidas en una ciudad con intensa actividad agroindustria y resultados gestacionales adversos

Objetivo: analisar a prevalência e os efeitos da exposição aos agrotóxicos sobre a ocorrência de desfechos gestacionais adversos. Método: estudo transversal de base populacional, constituído de 275 mulheres selecionadas a partir das áreas de cobertura das Estratégia da Saúde da Família, com idade igual ou maior que 18 anos. A coleta de dados ocorreu por meio da aplicação de um questionário estruturado, construído a partir da junção e adaptação de dois instrumentos validados, sendo um de condições de saúde autorreferida e um questionário de identificação do perfil de exposição familiar aos agrotóxicos. A análise de dados se deu por meio de análise bivariada, estratificada e regressão multivariada de Poisson. Resultados: houve uma incidência de aborto e natimortos de 20,73% na amostra, cujas variáveis associadas a estes desfechos de gravidez foram, contato atual com agrotóxicos, intoxicação prévia pelos agroquímicos e cor não branca, sendo observado a interação entre as mulheres que lavam roupas utilizadas na manipulação de agrotóxicos. Conclusão: há evidências de que a exposição materna a agrotóxicosse encontrapossivelmente associada a maior ocorrência de óbito fetal (aborto e natimorto).

Objective: to analyzethe prevalence and effects of exposure to pesticides on the occurrence of adverse pregnancy outcomes. Method: population-based cross-sectional study, consisting of 275 women selected from the areas covered by the Family Health Strategy, aged 18 years or older. Data collection took place through the application of a structured questionnaire, constructed from the combination and adaptation of two validated instruments, one of which is self-reported health conditions and a questionnaire to identify the profile of family exposure to pesticides. Data analysis was performed using bivariate and stratified analysis and multivariate Poisson regression. Results: there was an incidence of miscarriage and stillbirths of 20.73% in the sample, whose variables associated with these pregnancy outcomes were current contact with pesticides, previous intoxication by agrochemicals and non-white color, observing the interaction between women who wash clothes used in handling pesticides. Conclusion: there is evidence that maternal exposure to pesticides is possibly associated with a higher occurrence of fetal death (abortion and stillbirth).

Objetivo: analizar la prevalencia y los efectos de la exposición a plaguicidas en la ocurrencia de resultados adversos del embarazo. Método: estudio transversal de base poblacional, compuesto por 275 mujeres seleccionadas de las áreas de cobertura de la Estrategia Salud de la Familia, con edad igual o superior a 18 años. La recolección de datos se realizó mediante la aplicación de un cuestionario estructurado, construido a partir de la combinación y adaptación de dos instrumentos validados, uno de los cuales es el autoinforme de condiciones de salud y un cuestionario para identificar el perfil de exposición familiar a plaguicidas. El análisis de datos se realizó mediante análisis bivariado y estratificado y regresión de Poisson multivariada. Resultados: hubo una incidencia de abortos y mortinatos de 20,73% en la muestra, cuyas variables asociadas a estos desenlaces de embarazos fueron contacto actual con plaguicidas, intoxicaciones previas por agroquímicos y color no blanco, observándose la interacción entre mujeres que lavan ropa usada en manejo de pesticidas. Conclusión: existe evidencia de que la exposición materna a pesticidas posiblemente esté asociada con una mayor ocurrencia de muerte fetal (aborto y muerte fetal).

Revisão: exposição pré-natal e pesticidas / Revisión: exposición prenatal y pesticidas / Review: Prenatal Exposure and Pesticides

Resumo Introdução: Para uma proteção adequada da saúde humana, especialmente em populações de gestantes e crianças vulneráveis, é necessário estimar com precisão os riscos nos efeitos na saúde da exposição ao pesticida. Objetivo: Identificar por meio de artigos selecionados em pesquisa eletrônica nas bases de dados PubMed y Science Direct que relacionaram os efeitos dos pesticidas com problemas na saúde das mulheres gravidas e seus recém-nascidos. Método: Nesta revisão, foram caracterizados estudos epidemiológicos que avaliam os efeitos na saúde pela exposição aos pesticidas, especialmente organofosforados (OPs) e organoclorados (OCs). Também analisasse estudos nos quais são realizadas avaliações de exposição em gestantes que moram em áreas agrícolas, homens com exposição ocupacional, crianças nascidas e residentes nas áreas onde são utilizados agrotóxicos; estudos associados ao uso de agrotóxicos com anormalidades citogenéticas em recém-nascidos, danos ao DNA e efeitos adversos ao nascer pela exposição aos pesticidas. Resultados: Os resultados dos estudos forneceram evidências para sustentar a hipótese de que a exposição a agrotóxicos está negativamente associada aos efeitos na qualidade de vida de crianças cujos pais estão expostos aos agrotóxicos, uma vez que as crianças estão expostas a diferentes níveis de agrotóxicos durante a gravidez, nascimento e crescimento. Conclusão: A validade dos estudos revisados epidemiológicos y científicos é fortemente reforçada pela avaliação da exposição com base na quantificação dos biomarcadores moleculares.

Resumen Introducción: Para una adecuada protección de la salud humana, especialmente en poblaciones de mujeres embarazadas y niños vulnerables, es necesario estimar con precisión los riesgos en los efectos de la exposición de los plaguicidas en la salud. Objetivo: Identificar artículos seleccionados a través de una búsqueda electrónica en las bases de datos PubMed y Science Direct que relacionaban los efectos de los plaguicidas con problemas de salud en las mujeres embarazadas y sus recién nacidos. Métodos: Esta revisión caracterizó estudios epidemiológicos que evalúan los efectos sobre la salud de la exposición a los plaguicidas, especialmente los organofosforados (OP) y los organoclorados (OC). También se analizaron estudios en los que se evaluó la exposición en mujeres embarazadas que viven en zonas agrícolas, hombres con exposición ocupacional, niños nacidos y residentes en zonas donde se utilizan plaguicidas, estudios asociados al uso de plaguicidas con anomalías citogenéticas en los recién nacidos, daños en el ADN y efectos adversos al nacimiento por exposición a plaguicidas. Resultados: Los resultados de los estudios aportaron pruebas que apoyan la hipótesis de que la exposición a los plaguicidas se asocia negativamente con los efectos en la calidad de vida de los niños cuyos padres están expuestos a los plaguicidas, ya que los niños están expuestos a diferentes niveles de plaguicidas durante el embarazo, el embarazo, el nacimiento y el crecimiento. Conclusión: La validez de los estudios epidemiológicos y científicos revisados se ve muy reforzada por la evaluación de la exposición basada en la cuantificación de biomarcadores moleculares.

Avaliação do neurodesenvolvimento de crianças com e sem exposição intrauterina ao vírus zika assintomáticas ao nascimento / Neurodevelopmental assessment of children with and without intrauterine exposure to Zika virus who are asymptomatic at birth

Introdução: a exposição intrauterina ao vírus Zika (ZIKV) pode causar atrasos no neurodesenvolvimento das crianças nascidas com ou sem sintomas da Síndrome Congênita da Zika. Entretanto poucos estudos têm comparado o neurodesenvolvimento entre as crianças com exposição intrauterina ao ZIKV nascidas aparentemente assintomáticas e crianças sem exposição. Objetivo: avaliaro efeito da exposição intrauterina ao ZIKV sobre o neurodesenvolvimento de crianças assintomáticas. Método: estudo transversal aninhado numa coorteprospectiva em andamento (coorte Rio de Janeiro) de crianças nascidas durante a epidemia de Zika no Brasil que avaliou e comparou o escore composto de crianças expostas e não expostas ao ZIKV testadas pela Escala Bayley de desenvolvimento de lactentes e pré escolares - terceira edição-Bayley III. Resultados: foram avaliadas 143 crianças de 11 a 39 meses de idade incluindo 65 com exposição ao ZIKV e 72 sem exposição. Sessenta crianças (42%) apresentaram alteração do desenvolvimento em pelo menos um domínio, porém em relação aos controles não expostos, as crianças com exposição ao ZIKV não apresentaram diferenças significativas no resultado da avaliação nos domínios cognitivo, linguagem e motor. Nesse estudo o atraso mais frequente encontrado em ambos os grupos foi nalinguagem (28%).Conclusão: esses achados combinados com o fato que as crianças nascidas durante a epidemia ainda estão na idade pré-escolar reforçam a importância de se seguir acompanhando seu neurodesenvolvimento até a idade escolar uma vez que ainda não se tem conhecimento bastante sobre manifestações de atrasos tardios que podem não ser evidenciados nos primeiros anos de vida.

Background: Intrauterine exposure to Zika virus (ZIKV) has been hypothesized to cause neurodevelopmental delays among children born with and without apparent symptoms for Congenital Zika Syndrome. However, few studies have compared neurodevelopment between the intrauterine ZIKV-exposed but apparently asymptomatic children and ZIKV-unexposed children. Objective: To assess the effect of intrauterine exposure to ZIKV on neurodevelopment of asymptomatic children. Method: A cross-sectional study including children followed-up as a part of an ongoing prospective cohort (Rio de Janeiro cohort) born during the ZIKV epidemicin Brazil that evaluated and compared the composite score results of exposed and no-exposed children tested by the Bayley Scales of Infant and Toddler Development 3rd edition Bayley III. Results: 143 children aged 11 to 39 months were evaluated including 65 with intrauterine exposition to ZIKV and 72 controls no exposed. Sixty children (42%) were delayed in at least one developmental domain but regarding to the controls the children with intrauterine exposition to ZIKV did not present significant differences in the result of the evaluation in the assessment of cognitive, language and motor domains. In this study, the most frequent delay in both groups was in language (28%). Conclusion: These findings combined with the knowledge that children born during the epidemic are still at preschool age reinforce the importance of continued follow-up at the school ages since there is still not enough knowledge about late onset manifestations that are not noticeable in the first years of life.

Tuberculosis congénita - el desafío parte con la madre / Congenital tuberculosis - the challenge starts with the mother

La tuberculosis es la enfermedad infecciosa por un solo agente que provoca más muertes en el mundo. A la fecha, no hay un registro de casos de embarazadas con tuberculosis en el mundo ni en Chile, y menos de los casos de tuberculosis congénita. El diagnóstico en ambas situaciones suele ser tardío y con malos resultados clínicos. Se presenta una revisión de la literatura con relación a tuberculosis perinatal y dos casos clínicos de los binomios madre e hijo afectados.

Tuberculosis is the single agent infectious disease that causes the most deaths in the world. To date, there is no record of pregnant women with tuberculosis in the world or in Chile, even less of congenital tuberculosis. Diagnosis in both situations is usually late and with poor clinical results. A literature review is presented in relation to perinatal tuberculosis and two clinical cases of affected mother and child binomials.

Effect of maternal exposure to lipopolysaccharide during pregnancy on allergic asthma in offspring in mice / 中华儿科杂志

Objective: To investigate the effect of maternal exposure to lipopolysaccharide during pregnancy on allergic asthma in offspring in mice. Methods: Animal experimental research was carried out from June 2019 to June 2021.Pregnant C57BL/6J mice were randomly divided into 2 groups by intraperitoneal injection with 7 μg/kg lipopolysaccharide (LPS) or phosphate buffered saline (PBS) at day 15.5 of gestation. After birth, 6 offspring were randomly chosen from each group at the age of 4 weeks, and stimulated with house dust mites (HDM) or PBS, further divided into 4 groups, such as LPS+PBS group, LPS+HDM group, PBS+PBS group, PBS+HDM group, with 3 mice in each group. The cough and wheezing were observed, the histological changes in lung tissue were examined after HE staining, and the expression of inflammatory factors including interleukin (IL)-4, IL-6, IL-17A, IL-23, interferon (IFN)-α and IFN-β in the lung tissue were detected by high-throughput liquid protein chip detection. T test or rank sum test was used for the comparison among these groups. Results: The asthma-like airway inflammation was more obvious in PBS+HDM group after stimulated by HDM than that in PBS+PBS group, nevertheless, this manifestation in LPS+HDM group was milder than that in PBS+HDM group. HE staining showed that inflammatory cell aggregation in the lung tissue in PBS+HDM group was significantly higher than that in PBS+PBS group (4.0 (3.5, 4.0) vs. 0 (0, 0.5), Z=2.02, P=0.043), while it was much lower in LPS+HDM group compared to PBS+HDM group (1.0 (0.5, 1.5) vs. 4.0 (3.5, 4.0), Z=1.99, P=0.046). High-throughput liquid protein chip detection of lung tissue showed that IL-6, IL-23 and IFN-β levels were significantly higher in PBS+HDM group when compared to those in PBS+PBS group ((114±3) vs. (94±4) ng/L, (210±4) vs. (173±7) ng/L, (113±2) vs. (94±4) ng/L, t=4.37, 4.84, 3.96, all P<0.05), while the levels of IL-6, IL-23, IFN-α, IFN-β in LPS+HDM group were significantly lower than those in PBS+HDM group ((87±5) vs. (114±3) ng/L, (171±7) vs. (210±4) ng/L, (16.1±0.6) vs. (20.9±0.3) ng/L, (95±1) vs. (113±2) ng/L, t=5.07, 5.07, 7.28, 7.47, all P<0.05). Conclusions: Prenatal low dose LPS exposure can reduce offspring's airway inflammatory reactions and prevent the development of allergic disease. Maternal infection during pregnancy may affect the occurrence and development of allergic asthma in offspring.

Prenatal pyrethroid pesticides exposure and neurodevelopment of 2-year-old children: a birth cohort study / 中华预防医学杂志

Objective: To investigate the influence and critical windows of prenatal exposure to pyrethroid pesticides (PYRs) on neurodevelopment of 2-year-old children. Methods: The subjects of this study were derived from the Xuanwei Birth Cohort. A total of 482 pregnant women who participated in the rural district of Xuanwei birth cohort from January 2016 to December 2018 were included. Maternal urinary concentrations of PYRs metabolites during 8-12 gestational weeks, 20-23 gestational weeks and 32-35 gestational weeks were measured with ultra high performance liquid chromatography system coupled with a tandem mass spectrometry detector. Child neurodevelopment was evaluated with the Bayley Scales of Infant and Toddler Development-Third Edition at 2 years of age. Multivariate linear regression models and binary logistic regression models were used to assess the association between PYRs exposure during pregnancy and children's neurodevelopment. Results: A total of 360 mother-child pairs had complete data on maternal urinary PYRs metabolites detection and children's neurodevelopment assessment. The detection rate of any one PYRs metabolites during the first, second and third trimester were 93.6% (337/360), 90.8% (327/360) and 94.2% (339/360), respectively. The neurodevelopmental scores of Cognitive, Language, Motor, Social-Emotional, and Adaptive Behavior of 2-year-old children were (102.3±18.9), (100.2±16.3), (102.0±20.3), (107.8±23.3) and (85.8±18.6) points, respectively. After controlling for confounding factors, 4-fluoro-3-phenoxybenzoic acid (4F3PBA, one of PYRs metabolites) exposure in the first trimester reduced Motor (β=-5.02, 95%CI: -9.08, -0.97) and Adaptive Behavior (β=-4.12, 95%CI:-7.92, -0.32) scores of 2-year-old children, and increased risk of developmental delay of adaptive behavior (OR=2.07, 95%CI:1.13-3.82). Conclusion: PYRs exposure during the first trimester of pregnancy may affect neurodevelopment of 2-year-old children, and the first trimester may be the critical window.

Gene-environment interactions related to maternal exposure to environmental and lifestyle-related chemicals during pregnancy and the resulting adverse fetal growth: a review

BACKGROUND@#There are only limited numbers of reviews on the association of maternal-child genetic polymorphisms and environmental and lifestyle-related chemical exposure during pregnancy with adverse fetal growth. Thus, this article aims to review: (1) the effect of associations between the above highlighted factors on adverse fetal growth and (2) recent birth cohort studies regarding environmental health risks.@*METHODS@#Based on a search of the PubMed database through August 2021, 68 epidemiological studies on gene-environment interactions, focusing on the association between environmental and lifestyle-related chemical exposure and adverse fetal growth was identified. Moreover, we also reviewed recent worldwide birth cohort studies regarding environmental health risks.@*RESULTS@#Thirty studies examined gene-smoking associations with adverse fetal growth. Sixteen maternal genes significantly modified the association between maternal smoking and adverse fetal growth. Two genes significantly related with this association were detected in infants. Moreover, the maternal genes that significantly interacted with maternal smoking during pregnancy were cytochrome P450 1A1 (CYP1A1), X-ray repair cross-complementing protein 3 (XRCC3), interleukin 6 (IL6), interleukin 1 beta (IL1B), human leukocyte antigen (HLA) DQ alpha 1 (HLA-DQA1), HLA DQ beta 1 (HLA-DQB1), and nicotinic acetylcholine receptor. Fetal genes that had significant interactions with maternal smoking during pregnancy were glutathione S-transferase theta 1 (GSTT1) and fat mass and obesity-associated protein (FTO). Thirty-eight studies examined the association between chemical exposures and adverse fetal growth. In 62 of the 68 epidemiological studies (91.2%), a significant association was found with adverse fetal growth. Across the studies, there was a wide variation in the analytical methods used, especially with respect to the genetic polymorphisms of interest, environmental and lifestyle-related chemicals examined, and the study design used to estimate the gene-environment interactions. It was also found that a consistently increasing number of European and worldwide large-scale birth cohort studies on environmental health risks have been conducted since approximately 1996.@*CONCLUSION@#There is some evidence to suggest the importance of gene-environment interactions on adverse fetal growth. The current knowledge on gene-environment interactions will help guide future studies on the combined effects of maternal-child genetic polymorphisms and exposure to environmental and lifestyle-related chemicals during pregnancy.

Living frisbees: riesgos de patologías mentales en niños y niñas expuestos a thc durante su gestación / Living frisbees: risks of mental pathologies in boys and girls exposed to thc during their pregnancy

La Cannabis sativa es una planta que contiene componentes psicoactivos (principalmente tetrahidrocannabinol) y actualmente corresponde a la droga ilícita más consumida a nivel mundial. Además, desde el área de la salud mental, ha habido un creciente interés en evaluar la relación entre el consumo de marihuana y el desarrollo de trastornos mentales. En este contexto, considerando tanto este creciente aumento en su consumo a nivel mundial y el interés por conocer si está involucrada en la patogénesis de patologías de la esfera psiquiátrica, es clave analizar qué posibles riesgos de desarrollar patologías mentales presentan aquellos niños expuestos al tetrahidrocannabinol durante la gestación. A partir de esta situación, el objetivo de este FRISBEEs es determinar si los niños/as expuestos a THC durante su gestación tienen un mayor riesgo de patologías mentales, en comparación a aquellos niños no expuestos durante su gestación. Los materiales y métodos utilizados para responder esta pregunta fueron obtenidos a partir de una búsqueda bibliográfica en dos bases de datos, donde se analizó la evidencia disponible, y se seleccionó el estudio primario titulado "Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent psychotic symptoms in offspring", ya que era el que más se aproximaba a poder responder nuestra pregunta clínica. Este se analizó de forma crítica, llegando al resultado de que el estudio no fue concluyente en establecer una asociación entre el uso de cannabis y síntomas psicóticos. Como conclusión, dado que no se pudo llegar a establecer una asociación entre el uso de cannabis y el desarrollo de patologías mentales, se debería realizar más investigación sobre el tema dado la magnitud del consumo de cannabis a nivel mundial, para así poder llegar a conclusiones clínicas basadas en la evidencia y poder dar recomendaciones clínicas a las pacientes embarazadas.

Cannabis sativa is a plant that contains psychoactive components (mainly tetrahydrocannabinol) and currently corresponds to the most widely consumed illicit drug worldwide. In addition, from the area of mental health, there has been a growing interest in evaluating the relationship between marijuana use and the development of mental disorders. In this context, considering both this growing increase in its consumption worldwide and the interest in knowing if it is involved in the pathogenesis of pathologies in the psychiatric sphere, it is essential to analyze what possible risks of developing mental pathologies present those children exposed to tetrahydrocannabinol during gestation. Based on this situation, the objective of this FRISBEEs is to determine whether children exposed to THC during their pregnancy have a greater risk of mental pathologies, compared to those children not exposed during their pregnancy. The materials and methods used to answer this question were obtained from a bibliographic search in two databases, where the available evidence was analyzed, and the primary study entitled "Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent psychotic symptoms in offspring ", as he was the closest to answering our clinical question. This was critically analyzed, reaching the result that the study was not conclusive in establishing an association between the use of cannabis and psychotic symptoms. In conclusion, given that it was not possible to establish an association between the use of cannabis and the development of mental pathologies, more research should be carried out on the subject given the magnitude of cannabis use worldwide, in order to reach conclusions. evidence-based clinics and to be able to give clinical recommendations to pregnant patients

Can Prenatal and Postnatal Cell Phone Exposure Increase Adverse Maternal, Infant and Child Outcomes? / A exposição pré-natal e pós-natal a telefones celulares pode aumentar os resultados adversos para mães, bebês e crianças?

Abstract Objective To determine the association between maternal mobile phone use and adverse outcomes in infants, children, and mothers. Method In March 202, we conducted a search on the MEDLINE, Embase, and Scopus databases. Data extraction and an assessment of the quality of the studies were performed by two authors. The quality of the studies was assessed using the checklist of the Newcastle-Ottawa scale. Results Studies assessing behavioral problems in infants aged 6 to 18 months reported null findings. However, an increased risk of emotional and behavioral disorders was observed in children aged between 7 and 11 years whose mothers had been exposed to cell phones. The findings regarding the association between maternal cell phone exposure and adverse outcomes in children aged 3 to 5 are controversial. A study found a significant association between the call time (p=0.002) or the history of mobile phone use (in months) and speech disorders in the children (p=0.003). However, another study found that maternal cell phone use during pregnancy was not significantly associated with child psychomotor and mental developments. Inconclusive results were observed about the adverse outcomes in fetuses, such as fetal growth restriction or t scores for birth weight in cell phone users as opposed to non-users. On the contrary, the children ofmothers who were cell phone users had a lower risk of scoring low on motor skills. Similar results were observed regarding the adverse outcomes of cell phone use in infants, such as fetal growth restriction or low birth weight, and the risk of preeclampsia was lower among subjects with medium and high cell phone exposure, as opposed to those with low exposure. Conclusion Studies on behavioral problems have reported different postnatal results, such as null findings among infants and a positive association in children.

Resumo Objetivo Determinar a associação entre o uso de telefone celular pela mãe e os resultados adversos em recém-nascidos crianças e mães. Método Em março de 2020 realizou-se uma pesquisa nas bases de dados MEDLINE, Embase e Scopus. A extração de dados e avaliação da qualidade dos estudos foram realizadas por dois autores. A qualidade dos estudos foi avaliada por meio da lista de verificação da escala Newcastle-Ottawa. Resultados Estudos que avaliavam problemas comportamentais em recém-nascidos de 6 a 18 meses relataram resultados nulos. No entanto um risco aumentado de transtornos emocionais e comportamentais foi observado em crianças de 7 a 11 anos de idade cujas mães foram expostas a telefones celulares. Os resultados relacionados à associação entre a exposição materna a celulares e resultados adversos em crianças de 3 a 5 anos são controversos. Um estudo encontrou associação significativa entre o tempo de ligação (p=0.002) ou o histórico de uso de celular (emmeses) e distúrbios de fala nas crianças (p=0.003). No entanto outro estudo descobriu que o uso de telefone celular pela mãe durante a gravidez não estava significativamente associado ao desenvolvimento psicomotor e mental da criança. Resultados inconclusivos foram observados com relação aos resultados adversos de fetos como restrição de crescimento intrauterino ou valores de t para peso ao nascer em usuárias de telefone celular em oposição a não usuárias. Pelo contrário os filhos de mães usuárias de telefone celular apresentaram menor risco de pontuação baixa em habilidades motoras. Resultados semelhantes foram observados com relação a resultados adversos em recém-nascidos como restrição de crescimento intrauterino ou valores de peso ao nascere o risco de pré-eclâmpsia foimenor em indivíduos comexposição média e alta a celulares em oposição àqueles com baixa exposição. Conclusão Estudos sobre problemas comportamentais relataram resultados diferentes no pós-natal como achados nulos em recém-nascidos e associação positiva emcrianças.

Intrauterine alcohol exposure disturbs trabecular morphology in the Sprague Dawley rat humerus epiphysis up to 3- weeks postnatally / La exposición al alcohol intrauterino altera la morfología trabecular en la epífisis del húmero de la rata Sprague Dawley hasta 3 semanas después del nacimiento

SUMMARY: Gestational alcohol exposure inhibits neurological as well as bone growth and development both in fetal and postnatal life. Stunted stature, osteoporosis and fractures in adult life are some of the adverse effects. While the impact of intrauterine alcohol on the brain has been extensively investigated, studies on the effects on bone are relatively few. Therefore, our study aimed to examine the impact of prenatal alcohol exposure on bone microarchitecture in 3-week-old rats using Micro-focus X-Ray Computed Tomography (Micro CT). Time mated pregnant Sprague Dawley dams (13) were randomly placed into 3 groups: ethanol (n=5), saline control (n=5) and untreated control (n=3). The former 2 groups received treatment with 0.015ml/g of 25.2 % ethanol and 0.9 % saline, respectively, for the first 19 days of gestation. The untreated group received no treatment. The pups remained with their dams until termination at 21 days of age. From each dam, 2 pups were collected resulting in: ethanol (n=10), saline controls (n= 10) and untreated controls (n = 6). The humeri of the pups were dissected and scanned using a 3D-μCT scanner (Nikon XTH 225L) at 15μm resolution. Trabecular and cortical parameters were analysed using Volume Graphics Studio® software following reconstruction. Results showed a decrease in trabecular size, spaces, thickness, and volume. There was a decrease in cortical bone area in the ethanol group compared to the controls. These findings may suggest that osteoporosis and fractures seen as gestational alcohol effects may be due to compromised trabecular structure.

RESUMEN: La exposición al alcohol durante la gestación inhibe el crecimiento y desarrollo neurológico y óseo tanto en la vida fetal como posnatal. Algunos de los efectos adversos incluyen la estatura atrofiada, osteoporosis y fracturas en la vida adulta. Si bien se ha estudiado el impacto del alcohol intrauterino en el cerebro, los estudios sobre los efectos en los huesos son escasos. Por lo tanto, nuestro estudio tuvo como objetivo examinar el impacto de la exposición prenatal al alcohol en la microarquitectura ósea en ratas de 3 semanas de edad utilizando Tomografía Computarizada de Rayos X Micro-focus (Micro CT). Las hembras de Sprague Dawley preñadas con apareamiento temporal (13) se colocaron aleatoriamente en 3 grupos: etanol (n = 5), control de solución salina (n = 5) y control sin tratar (n = 3). Los primeros 2 grupos recibieron tratamiento con 0,015 ml /g de etanol al 25,2 % y solución salina al 0,9 %, respectivamente, durante los primeros 19 días de gestación. El grupo no tratado no recibió tratamiento. Las crías permanecieron con sus madres hasta la terminación a los 21 días de edad. De cada madre, se recolectaron 2 crías que dieron como resultado: etanol (n = 10), controles salinos (n = 10) y controles no tratados (n = 6). Se diseccionaron y escanearon los húmero de las crías usando un escáner 3D-μCT (Nikon XTH 225L) a una resolución de 15 μm. Los parámetros trabeculares y corticales se analizaron utilizando el software Volume Graphics Studio® después de la reconstrucción. Los resultados mostraron una disminución en el tamaño trabecular, los espacios, el grosor y el volumen. Hubo una disminución en el área del hueso cortical en el grupo de etanol en comparación con los controles. Estos hallazgos pueden sugerir que la osteoporosis y las fracturas por causa de los efectos del alcohol gestacional se pueden deber a una estructura trabecular comprometida.

Repercusión de la covid-19 en la salud materno-infantil / Covid-19 repercussions on maternal and infantile health

RESUMEN El año 2020 ha sorprendido al planeta con la pandemia de la covid-19. Este artículo tiene como objetivo reflexionar sobre las repercusiones del nuevo coronavirus en la salud materno-infantil. Pese al poco tiempo transcurrido desde el inicio de la pandemia, en las embarazadas con covid-19 se han descrito algunas comorbilidades, así como alteraciones placentarias, abortos espontáneos, muertes fetales y maternas, e incremento en los partos por cesárea y nacimientos pretérminos. Los riesgos potenciales demandarán una vigilancia estrecha del comportamiento del embarazo en el futuro inmediato. Por otra parte, del total de la población afectada por la covid-19, los pacientes en edad pediátrica representan entre el 1 y el 2 %, y la mayoría presentan manifestaciones clínicas leves. No obstante, en los menores de un año cerca del 10 % puede evolucionar a formas severas o críticas. De especial interés ha sido la presentación del síndrome inflamatorio multisistémico en niños, debido a su gravedad y riesgo para la vida. En los recién nacidos, la infección por SARS-CoV-2 podría asociarse a dos formas, de acuerdo al momento de adquisición: la covid perinatal y la postnatal. Hasta el momento, las evidencias sobre la existencia de la vía de transmisión vertical son insuficientes, pero no pueden ser descartadas. En conclusión, por tratarse de un fenómeno en desarrollo, aún quedan muchas interrogantes sobre los efectos de la covid-19 en la salud materna e infantil, que demandarán en los próximos meses un gran esfuerzo por parte de investigadores, médicos de asistencia y directivos (AU).

ABSTRACT The year 2020 has surprised the planet with the covid-19 pandemics. This article is aimed to reflect on the repercussions of the novel coronavirus on maternal and infantile health. Despite of the short time elapsed from the onset of the pandemics, some comorbidities have been described in pregnant women with COVID-19, as well as placental anomalies, spontaneous abortions, stillbirths, maternal deaths, and an increasing number on cesarean section and preterm births. The potential risk will demand a close surveillance of pregnancy behavior in the near future. Moreover, pediatric patients are among 1 and 2% of the population affected by COVID-19, and most of them show mild clinical signs. Nevertheless, about 10% of the children aged less than a year may evolve to severe and critical forms. The multisystem inflammatory syndrome in children has been of special interest, due to its severity and risk for life. In newborns, SARS-CoV-2 infection could be associated to two forms according to the acquisition time: perinatal and postnatal COVID-19. Up to the moment, evidences on vertical transmission are insufficient, but they could not be discarded. In conclusion, as this is an ongoing phenomenon, many questions about the effects of COVID-19 on maternal and infantile health are pending; they will demand a crucial effort by researchers, health providers and decision makers (AU).

Effects of prenatal tobacco smoke on cerebellum histomorphological changes at critical developmental stages in CD-1 mice / Efectos del humo de tabaco en los cambios histomorfológicos del cerebelo en las etapas críticas del desarrollo prenatal en ratones CD-1

SUMMARY: In this study the consequences of prenatal exposure to tobacco smokes on the histo-morphological changes of cerebellum was assessed by comparing the smoker mice to the nonsmoker mice. A total of 30 pregnant cd-1 mice were divided into three groups of 10 mice each and with two replicates per group (5 mice each). Following acclimation for five days, the mice were placed in a special modified smoking machine for 2 hours per day over a two- and three-week period for group two and group three, respectively. Group one was considered as a control group. Mice in the control group were exposed simultaneously to fresh air from the room, while those in the treatment groups were exposed to tobacco smoke from six commercial filter cigarettes, containing 0.8 mg of nicotine, 10 mg of tar, and 10 mg of carbon monoxide, for three 1-hour exposure periods every day for three weeks. The mice in the control group were exposed to room air for three 1-hour periods every day for the same period of three weeks. The results from this study showed a correlation between maternal smoking and histological changes in Neuron purkinjense (Purkinje cells) of the cerebellum. They also showed that prenatal smoking period may have caused more damage in the histology and structure of Neuron purkinjense in some juvenile mice. An increased incidence of morphology damage of the cerebellum's Neuron purkinjense' structures was also observed in fetuses with prolonged exposure to tobacco smoking. Exposure of in utero maternal smoking may interfere with brain biological development parameters, giving rise to structural abnormalities of the cerebellum. This study concluded that tobacco smoke exposure to pregnant mice may affect neurodevelopment which may induce behavioural changes as a result of reduced cerebellar size and function.

RESUMEN: Se evaluaron los efectos producidos por la exposición prenatal al humo de tabaco en ratones expuestos y no expuestos y los cambios histomorfológicos observados en el cerebelo en ambos grupos. Un total de 30 ratones cd-1 preñados se dividieron en tres grupos de 10 ratones cada uno y con dos réplicas por grupo (5 ratones cada uno). Después de la aclimatación durante cinco días, los ratones se colocaron en una máquina de fumar modificada, especial durante 2 horas al día, durante un período de dos y tres semanas para el grupo dos y el grupo tres, respectivamente. El grupo uno se consideró como grupo control. Los ratones del grupo de control fueron expuestos simultáneamente al aire limpio de la habitación, mientras que los grupos de tratamiento fueron expuestos al humo de tabaco de seis cigarrillos comerciales, que contenían 0,8 mg de nicotina, 10 mg de alquitrán y 10 mg de monóxido de carbono. durante tres períodos de 1 hora diariamente, durante tres semanas. Los ratones del grupo de control se expusieron al aire ambiente durante tres períodos de 1 hora todos los días durante el mismo período de tres semanas. Los resultados de este estudio mostraron una correlación entre el tabaquismo materno y los cambios histológicos en las neuronas purkinjenses (células de Purkinje). Se observó además que el período de tabaquismo prenatal puede haber causado mayor daño en la histología y estructura de las neuronas purkinjenses en algunos ratones jóvenes. También se observó una mayor incidencia de daño morfológico de las estructuras de las neuronas purkinjenses del cerebelo en fetos con exposición prolongada al tabaquismo. La exposición al tabaquismo materno en el útero puede interferir con los parámetros de desarrollo biológico del cerebro, dando lugar a anomalías estructurales del cerebelo. Este estudio concluyó que la exposición al humo del tabaco en ratones preñados puede afectar el desarrollo neurológico, lo que puede inducir cambios de comportamiento como resultado de la reducción del tamaño y la función del cerebelo.

Air pollution and children's health-a review of adverse effects associated with prenatal exposure from fine to ultrafine particulate matter

BACKGROUND@#Particulate matter (PM), a major component of ambient air pollution, accounts for a substantial burden of diseases and fatality worldwide. Maternal exposure to PM during pregnancy is particularly harmful to children's health since this is a phase of rapid human growth and development.@*METHOD@#In this review, we synthesize the scientific evidence on adverse health outcomes in children following prenatal exposure to the smallest toxic components, fine (PM@*RESULTS@#Maternal exposure to fine and ultrafine PM directly and indirectly yields numerous adverse birth outcomes and impacts on children's respiratory systems, immune status, brain development, and cardiometabolic health. The biological mechanisms underlying adverse effects include direct placental translocation of ultrafine particles, placental and systemic maternal oxidative stress and inflammation elicited by both fine and ultrafine PM, epigenetic changes, and potential endocrine effects that influence long-term health.@*CONCLUSION@#Policies to reduce maternal exposure and health consequences in children should be a high priority. PM

Inflammatory state and autism-like behavioral phenotype of offspring induced by maternal exposure to low-dose chemical mixtures during pregnancy in mice / 浙江大学学报·医学版

To investigate the effects of maternal exposure to 13 chemicals mixture (CM) during pregnancy on pregnancy outcome and health status of maternal/offspring mice. C57BL/6 pregnant mice were given drinking water containing carbaryl dimethoate glyphosate methomyl methyl parathion triadimefon aspartame sodium benzoate calcium disodium ethylene diamine tetra-acetate ethylparaben butylparaben bisphenol A and acacia gum The effects of CM exposure on pregnancy outcome, health status of dams/offspring, levels of circulating inflammatory cytokines in dams/offspring and emotional related behaviors of offspring were evaluated. CM exposure during pregnancy had no significant effect on pregnancy outcome, liver function, body weight of the dams in late pregnancy and uterine/ovarian weight after delivery, however, it led to an increase in maternal serum IFN-γ level （<0.05）. CM exposure during pregnancy had no significant effect on the liver function of offspring, but increased the serum IFN-γ, prefrontal cortex IFN-γ, and TNF-α and hippocampus IFN-γ levels in the offspring（all <0.01）. In addition, the offspring of CM group showed significant abnormal emotion-related (autism-like) behaviors in adulthood, especially in male offspring. Low dose CM exposure during pregnancy may induce inflammation status in dams/offspring, and lead to autism-like behaviors in offspring, indicating the potential effects of low dose CM exposure on human maternal and infant health.

Maternal metal concentration during gestation and pediatric morbidity in children: an exploratory analysis

BACKGROUND@#The majority of studies linking exposure to metals with certain health outcomes focus on known toxic metals. Alternatively, this study assesses the extent to which exposure to a wider range of metals during gestation is associated with childhood morbidity.@*METHODS@#We analyzed the concentrations of 25 metals found in urine samples of 111 pregnant women of Arab-Bedouin origin collected prior to birth. In addition, we collected medical records on their offspring for six years following birth, including every interaction with HMOs, local hospitals, and pharmacies.@*RESULTS@#The main types of morbidities diagnosed and treated during this period were preterm births, malformations, asthma-like morbidity, cardiovascular and behavioral problems, and obesity. Multivariable analysis showed that offspring born before term were more likely to have been exposed to elevated maternal concentrations of zinc, thallium, aluminum, manganese, and uranium, all with adjusted relative risk above 1.40 for an increase by each quintile. Likewise, children with asthma had been exposed to higher levels of magnesium, strontium, and barium at gestation, while behavioral outcomes were associated with elevated biometals, i.e., sodium, magnesium, calcium, selenium, and zinc, as well as higher levels of lithium, cobalt, nickel, strontium, cadmium, vanadium, arsenic, and molybdenum. A heatmap of adjusted relative risk estimates indicates the considerable implications that exposure to metals may have for preterm birth and developmental outcomes.@*CONCLUSIONS@#The current study shows that perinatal exposure to metals is adversely associated with pediatric morbidity. Further such analyses on additional samples are warranted.

Effects of maternal exposure to arsenic on social behavior and related gene expression in F2 male mice

BACKGROUND@#Arsenic is a developmental neurotoxicant. It means that its neurotoxic effect could occur in offspring by maternal arsenic exposure. Our previous study showed that developmental arsenic exposure impaired social behavior and serotonergic system in C3H adult male mice. These effects might affect the next generation with no direct exposure to arsenic. This study aimed to detect the social behavior and related gene expression changes in F2 male mice born to gestationally arsenite-exposed F1 mice.@*METHODS@#Pregnant C3H/HeN mice (F0) were given free access to tap water (control mice) or tap water containing 85 ppm sodium arsenite from days 8 to 18 of gestation. Arsenite was not given to F1 or F2 mice. The F2 mice were generated by mating among control F1 males and females, and arsenite-F1 males and females at the age of 10 weeks. At 41 weeks and 74 weeks of age respectively, F2 males were used for the assessment of social behavior by a three-chamber social behavior apparatus. Histological features of the prefrontal cortex were studied by ordinary light microscope. Social behavior-related gene expressions were determined in the prefrontal cortex by real time RT-PCR method.@*RESULTS@#The arsenite-F2 male mice showed significantly poor sociability and social novelty preference in both 41-week-old group and 74-week-old group. There was no significant histological difference between the control mice and the arsenite-F2 mice. Regarding gene expression, serotonin receptor 5B (5-HT 5B) mRNA expression was significantly decreased (p < 0.05) in the arsenite-F2 male mice compared to the control F2 male mice in both groups. Brain-derived neurotrophic factor (BDNF) and dopamine receptor D1a (Drd1a) gene expressions were significantly decreased (p < 0.05) only in the arsenite-F2 male mice of the 74-week-old group. Heme oxygenase-1 (HO-1) gene expression was significantly increased (p < 0.001) in the arsenite-F2 male mice of both groups, but plasma 8-hydroxy-2'-deoxyguanosine (8-OHdG) and cyclooxygenase-2 (COX-2) gene expression were not significantly different. Interleukin-1β (IL-1β) mRNA expression was significantly increased only in 41-week-old arsenite-F2 mice.@*CONCLUSIONS@#These findings suggest that maternal arsenic exposure affects social behavior in F2 male mice via serotonergic system in the prefrontal cortex. In this study, COX-2 were not increased although oxidative stress marker (HO-1) was increased significantly in arsnite-F2 male mice.

Prevalencia de factores de riesgo ambientales prenatales en niños con trastorno del espectro autista controlados en un hospital de niños / Prevalence of prenatal environmental risk factors in children with autism spectrum disorder monitored in a children's hospital

INTRODUCCIÓN: El Trastorno del Espectro Autista (TEA) afecta al 1% de los niños y se ha demostrado que una de sus principales causas se debe a factores ambientales prenatales que afectan al feto durante el periodo gestacional. El objetivo fue estimar la prevalencia de factores de riesgo (FR) prenatales en niños con TEA menores de 8 años que se controlan en un Hospital de niños. MÉTODOS: Se realizó un estudio transversal descriptivo. Se aplicó una encuesta a los padres o tutores de los niños durante la espera a su control. Se realizó un análisis descriptivo de los datos. RESULTADOS: Participaron 76 madres de niños con TEA. Entre los niños predominó el sexo masculino, mediana de edad de 5,4 años, la mayoría puede hablar sin dificultad (78%) y un 28% tenía diagnóstico de alguna enfermedad crónica. La prevalencia de FR prenatales encontrados en este estudio es similar a las reportadas en otros estudios especialmente la edad de los padres, los años de educación materna, los abortos previos y el diagnóstico de enfermedades en el embarazo. Sin embargo, la prevalencia de factores como el embarazo de alto riesgo, el consumo materno de fármacos durante el embarazo, el parto prematuro y el consumo de tabaco y drogas durante el embarazo, fueron muy superiores en este estudio comparado con otros estudios, y podrían estar relacionadas con el diagnóstico de TEA en la infancia. CONCLUSIÓN: A partir de estos hallazgos, se establece una base para realizar estudios comparativos en el futuro.

INTRODUCTION: Autistic Spectrum Disorder (ASD) affects 1% of children and it has been shown that one of its main causes is due to prenatal factors that affect the fetus during the gestational period. The objective was to estimate the prevalence of prenatal risk factors (RF) in children with ASD under 8 years of age who are monitored in a Children's Hospital. METHODS: A descriptive cross-sectional study was carried out. A survey was applied to the parents or guardians of the children during the wait for their control. A descriptive analysis of the data was carried out. RESULTS: 76 mothers of children with ASD participated. The male sex predominated, the average age was 5.4 years, the majority could speak without difficulty (78%) and 28% had a diagnosis of a chronic disease. The prevalence of prenatal RF found in this study is similar to that reported in other studies, especially the age of the parents, the years of maternal education, previous abortions and the diagnosis of diseases in pregnancy. However, the prevalence of factors such as high-risk pregnancy, maternal consumption of medicines during pregnancy, preterm delivery and tobacco and drug use during pregnancy were much higher in this study compared to other studies, and could be related to the diagnosis of ASD in childhood. CONCLUSION: Based on these findings, a basis for comparative studies in the future is established.