一、母親手機使用與孩童神經認知行為發展 二、臍帶血中酚類化合物與胎兒生長發育之相關性

1. Exposure to maternal mobile phone use and children’s neurocognitive development 2. Association between phenolic compounds in umbilical cord blood and child growth

吳佩璇(Pei-Hsuan Wu)

指導教授 ： 陳保中

國立臺灣大學/公共衛生學院/職業醫學與工業衛生研究所/碩士(2012年)

https://doi.org/10.6342/NTU.2012.00261

摘要

第一部分
研究背景與目的：現今社會中手機使用已越趨頻繁，然而手機之電磁波暴露對於
孩童健康發展之不良影響仍有爭議。少數研究已探討手機暴露與孩童神經行為發
展間之相關性，但目前仍未有研究探討手機暴露與孩童智力之影響。本研究之目
的為，先描述從妊娠期到產後一年之母親手機使用情形，並進一步探討其手機使
用量和孩童神經行為發展與智力間之影響。
材料與方法：自2004 年5 月至2005 年2 月間，收集來自台灣北部地區不同醫療
院所的產婦及其新生兒為研究對象，最終納入133 對的產婦及其新生兒進行分析。
我們使用「嬰幼兒綜合發展測驗」(Comprehensive Developmental Inventory for Infants and Toddlers, 簡稱CDIIT) 以及「魏氏兒童智力量表第四版」(Wechsler Intelligence Scale for Children-Fourth edition, 簡稱WISC-IV) 評估孩童之神經行為發展與智力分數。另外，我們也使用「瑞文氏圖形推理測驗」(Standard Progressive Matrices, 簡稱SPM)評估母親的智力。藉由自填式問卷評估母親的手機使用量，再使用迴歸模式(regression model)進行統計分析。
結果：本研究發現，從妊娠期至產後一年，多數的母親每天手機的接聽通數皆少
於3 通，且每通電話之通話時間皆少於3 分鐘。研究結果並未發現手機暴露對於
孩童的神經行為發展有不良之影響。
結論：目前仍未有明確的證據足以證明手機之暴露會造成孩童神經行為之不良影
響，未來仍需要更多的研究針對此議題進行探討。

第二部分
研究背景與目的：雙酚A(BPA)、壬基酚(NP)與辛基酚(OP)為工業上常用之化學物
質，也時常存在日常生活的用品中。塑膠奶瓶、玩具、水瓶、罐頭食品、清潔劑…
等，皆會釋放出微量的酚類化合物。一般來說，這些酚類物質大多經由飲食而進
入人體，飲食攝入也是日常生活中最主要的暴露途徑。這些酚類物質也被歸類為
環境賀爾蒙之汙染物，研究指出此種物質可能會影響生殖系統之發育或胎兒之生
長與發育。然而，目前對於產前暴露酚類物質與其胎兒之出生結果與往後生長發
育之相關性仍不清楚。因此，本研究目的為分析臍帶血中雙酚A、壬基酚與辛基
酚濃度，並探討其與胎兒出生結果與往後生長發育之相關性。
材料與方法：本研究之401 位產後婦女與其單胞胎之胎兒，皆選自於台北出生世
代追蹤研究(Taiwan Birth Panel Study)。產後利用結構式問卷收集產婦產前之生活
習慣調查，並於生產時收集胎兒臍帶血。以極致液相層析─串聯質譜儀
(UPLC-MS/MS)分析臍帶血中酚類化合物之濃度。並進一步使用迴歸模式分析臍
帶血中酚類化合物與其胎兒之出生結果與往後生長發育之相關性。
結果：臍帶血中雙酚A、壬基酚與辛基酚之中位數濃度分別為1.50、60.97 以及
2.30 ng/mL。在迴歸模式中，調整相關之潛在干擾因子後，發現壬基酚和出生時
的頭圍(per ln unit: β = -0.13, 95% CI: -0.23, -0.03)呈顯著之負相關；關於往後生長發育的部分，發現壬基酚和頭圍(per ln unit: β = -0.10, 95% CI: -0.19, -0.01 for 0-18 months)與身高(per ln uint: β = -0.05, 95% CI: -0.10, -0.002 for 0-6 years)呈負相關。
結論：本研究結果顯示，臍帶血中壬基酚濃度和胎兒之出生頭圍與其往後的頭圍
和身高之發展呈負相關。但仍需要更多完整且長期的研究來進一步探討產前酚類
化合物與胎兒出生結果與生長發育之相關。

關鍵字

產前暴露 ； 手機 ； 孩童神經行為發展 ； 孩童智力 ； 酚類化合物 ； 胎兒與孩童生長發育

並列摘要

Part I
Background and objective: In today’s world, mobile phone use has been commonly and increased rapidly in many countries. Health effects of exposure to mobile phone use on the children are controversial. An association between exposure to mobile phone use and children’s neurodevelopment was reported but there are still no studies investigating the effect on children’s intelligence. We described the maternal mobile phone use from pregnancy to 12 months, and examined the association between exposure to mobile phone use and children’s neurocognitive development in young
children from the general population in Taipei, Taiwan.
Methods: The study was a part of the Taiwan Birth Panel Study. A total of 133 pairs of parents and their singleton child were recruited into this study. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) and Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) to assess child neurocognitive development. We also assessed the intelligence of the mothers using the Standard Progressive Matrices Plus (SPM+). Mothers completed the questionnaires to report their mobile phone use. Regression model was used to estimate the association between mobile phone exposure and children’s neurocognitive development.
Results: Most of the mothers took less than 3 phone calls per days, and the call duration was less than 3 minutes in each phone call from pregnancy to 12 months. In this study,
we found no significant association between maternal mobile phone use and neurocognitive development in young children.
Conclusions: There is no convincing evidence that maternal mobile phone use had an adverse effect on the neurocognitive development of children. Further studies are needed to explore the association of mobile phone use and children’s neurocognitive development.

Part II
Background and objective: Bisphenol A, nonylphenol, and octylphenol are widely used in our life, and they all classified as endocrine-disrupting compounds (EDCs) which could lead the adverse effect on children’s growth. Previous studies investigated the association between prenatal phenols exposure and birth outcomes, and the findings were inconsistent. In addition, most of these studies measured the levels of phenols in maternal blood or urine during pregnancy to regard as the prenatal exposure. Few studies measured the phenols levels in cord blood to represent the prenatal exposure of fetus. The objective of this study was to measure the phenols levels in cord blood and explore the effects of prenatal phenols exposure on birth size and growth.
Methods: The study was a part of the Taiwan Birth Panel Study. A total of 401 pairs of parents and their infants were recruited in this study. We used the ultra-performance
liquid chromatography – tandem mass spectrometry (UPLC/MS/MS) to measure the free form BPA, NP and OP in cord blood. Birth outcomes were obtained after delivery,and we followed up these children to obtain the growth data up to 6 years old. The association between phenols levels in cord blood and child growth was assessed using linear regression and mixed models.
Results: The median of BPA, NP, and OP concentration in cord blood were 3.10, 74.4, and 2.30 ng/mL, respectively. For birth outcomes, after adjusting the confounders, head circumference decreased by 0.13 cm (95% CI: -0.23, -0.03) in association with a 1-unit increase in ln-transformed NP concentration. Regarding the child growth, a 1-unit increase of ln-NP was significantly associated with a decrease in head circumference (β = -0.11, 95% CI: -0.21, -0.02 for 0-18 months), and height z-score (β = -0.06, 95% CI: -0.11, -0.01 for 0-6 years).
Conclusion: In this study, we observed an evidence of prenatal NP exposure may have an adverse effect on head circumference at birth and child growth in the early
childhood. However, among these young children, we didn’t find an effect of prenatal BPA and OP exposure on child growth. Therefore, further studies are needed to explore
the association between prenatal phenols exposure and child growth.

並列關鍵字

prenatal exposure ； mobile phone ； neurocognitive development ； phenol ； fetal and child growth ； young children

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