孕期間母體飲食暴露對其胎兒早期心理衛生發展之影響:世代分析研究

Exposure to Food Contaminants and the Associated Early Childhood Mental Health in France: The EDEN Cohort

林念蓁(Nien-Chen Lin)

指導教授 ： 詹長權

國立臺灣大學/醫學院/國際三校農業生技與健康醫療碩士學位學程/碩士(2021年)

https://doi.org/10.6342/NTU202103805

摘要

食品中污染物質與毒素對於孕婦的健康危害在過去許多研究中不斷被探討，然而，以懷孕期間暴露於食品污染物為主軸，探討其影響新生兒早期心智發展的統整性研究，較少被納入營養流行病學中。
這份研究旨在透過量化工具，探究食品污染物與毒素之產前暴露量與孩童3至8歲間心理健康發展的關聯性。本研究中的1289位母嬰配對樣本資料，是來自法國國家衛生研究院與2家分別位於普瓦捷與南錫之大學附屬醫院合作，所做的婦幼出生世代研究。研究主要分為兩部分，第一部分利用系列研究中，已透過社交行為表現量表評估、群體化軌跡模式計算之新生兒早期心理健康發展傾向，來清理資料並進行分組分析，包含注意力不足過動症、焦慮與憂鬱症狀、行為規範障礙症、利社會行為，以及上述症狀之綜合評估等應變項。第二部分則採用符合法國民情的飲食頻率問卷，所量化取得之454種食品污染物與毒素於孕期間被攝取的含量，作為自變項。進而透過機器學習演算法，探勘各污染物與毒素和負向心理健康發展之關聯強度，並剔除低重要性之自變項，以較保守之估計進行多元邏輯斯回歸分析。
本研究結果反映母體孕期間飲食習慣可能影響孩童心理健康發展，可作為未來學界進行實驗研究之數據參考，也為相關介入性研究的方法和指南奠下基礎。

關鍵字

食品污染物與毒素 ； 母嬰配對 ； 兒童心理衛生 ； 機器學習 ； 邏輯斯回歸

並列摘要

Studies have identified the health effects of mixtures of contaminants in foods on pregnant women; however, the comprehensive understanding of the correlation between chemical substances in foods and the subsequent offspring's early childhood mental health is lacking in regards to nutritional epidemiology. This study aimed at examining the linkage between the exposure to chemical substances through pre-natal diets and children's mental health from 3 to 8 years. We used data from 1289 children enrolled in the French EDEN birth cohort. Early childhood mental health development--- specifically, ADHD, Anxiety and Depression Symptoms, Conduct Disorder, and Prosocial Behaviors ---were assessed with mothers' submission of the Strengths and Difficulties Questionnaire (SDQ) responses at 3, 5 and 8 of age, from which the trajectories were derived using Group-based Trajectory Modeling. 454 food contaminants from pre-natal diets were identified using Food Frequency Questionnaire (FFQ), and further determined the weightiness based on the Variable Inclusion Probability (VIP) transformed by the machine learning tool, Elastic Net. The associations between chemical substances and early childhood mental health were analyzed in multivariate logistic regressions. This study has the advantage of allowing prediction, and will allow researchers to assess the causal impact of experimental manipulations on food contaminants during pregnancy and the early childhood mental health development. This research underpins the development of future research on intervention approaches and guidelines for pre-natal diets that will be able to improve the quality of life.

並列關鍵字

Food contaminants ； Mother-child cohort ； Early mental health ； Machine learning ； Logistic regression

參考文獻

Allen, J., Balfour, R., Bell, R., Marmot, M. (2014). Social determinants of mental health. International review of psychiatry, 26(4), 392-407.

Berger, M., Gray, J. A., Roth, B. L. (2009). The expanded biology of serotonin. Annual review of medicine, 60, 355-366.

Bhugra, D., Till, A., Sartorius, N. (2013). What is mental health? In: SAGE Publications Sage UK: London, England.

Charlson, F. J., Baxter, A. J., Dua, T., Degenhardt, L., Whiteford, H. A., Vos, T. (2015). Excess mortality from mental, neurological and substance use disorders in the Global Burden of Disease Study 2010. Epidemiology and psychiatric sciences, 24(2), 121-140.

Conference, I. H. (2002). Constitution of the World Health Organization. 1946. Bulletin of the World Health Organization, 80(12), 983.