Background

Growing evidence suggests that pesticide exposure may influence respiratory health, but data in young children are very limited. We examined the association of prenatal pesticide exposure with lower respiratory tract infections (LRTIs) and wheeze at one year of age in children from the Infants' Environmental Health (ISA) study in Costa Rica.

Methods

We measured seven pesticide metabolites, including ethylenethiourea (ETU, metabolite of mancozeb), in maternal urine samples collected repeatedly during pregnancy. For each woman, we averaged pesticide concentrations during each half of pregnancy (≤20 and >20 weeks of gestation) and across repeated samples collected over the course of pregnancy. We collected information about LRTIs (n = 355) and wheezing (n = 272) during the first year of life from mothers when their children were 11–19 months old. We fit multivariable logistic regression models using high (quartile 4) vs. low (quartiles 1–3) urinary pesticide concentrations as exposures and adjusted models for maternal age, education, parity, gestational age at birth, and child sex.

Results

Ten percent of the children had at least one LRTI and 39% had at least one episode of wheezing during their first year of life. Median (25-75th percentile) specific gravity-corrected urinary ETU concentrations during the first half, second half, and over the course of pregnancy were 3.4 (2.1–5.0), 3.3 (2.2–4.7), and 3.4 (2.4–5.0) ng/mL, respectively. We observed that high urinary ETU concentrations during the first half of pregnancy were associated with increased odds of LRTI (OR = 2.45; 95% CI: 0.96, 6.26), whereas high urinary ETU concentrations during the second half of pregnancy were associated with decreased odds of wheezing (OR = 0.50; 95% CI: 0.26, 0.96). We found that the association between high urinary ETU concentrations during the first half of pregnancy and LRTIs persisted among mother-child pairs with either high or low ETU concentrations during the second half. In contrast, the association of high urinary ETU concentrations during the second half of pregnancy with wheezing was attenuated when we simultaneously adjusted for urinary ETU concentrations during the first half. We observed null associations between other pesticide metabolites measured during pregnancy and respiratory outcomes.

Conclusions

Our data indicate that exposure to mancozeb/ETU during the first half of pregnancy may be associated with respiratory outcomes in the first year of life.

中文翻译：

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出生后第一年的产前农药暴露和呼吸健康结果：婴儿环境健康（ISA）研究的结果。

背景

越来越多的证据表明，接触农药可能会影响呼吸系统健康，但幼儿的数据非常有限。我们从哥斯达黎加的婴儿环境健康（ISA）研究中，研究了儿童暴露于产前农药与下呼吸道感染（LRTIs）和1岁时喘鸣的关系。

方法

我们在怀孕期间反复收集的孕妇尿液样品中测量了7种农药代谢物，包括亚乙基硫脲（ETU，代森锰锌的代谢物）。对于每位妇女，我们在怀孕的每个半月（≤20周和怀孕> 20周）以及在怀孕过程中收集的重复样本中平均农药浓度。我们 从母亲出生的第一年（孩子11至19个月 ）收集了有关LRTI（n = 355）和喘息（n = 272）的信息。我们使用高（四分位数）和低（四分之一至1-3）尿液农药浓度作为暴露量，并针对孕产妇年龄，教育程度，胎次，出生时胎龄和儿童性别调整了模型，以拟合多变量logistic回归模型。

结果

10％的儿童在其生命的第一年至少患有LRTI，39％的儿童患有至少一次喘息。在上半年，下半年和整个怀孕过程中，经重力校正的尿液ETU浓度中位数（25-75％）分别为3.4（2.1-5.0），3.3（2.2-4.7）和3.4（2.4-5.0） ng / mL。我们观察到，妊娠上半年尿ETU浓度高与LRTI机率增加相关（OR = 2.45； 95％CI：0.96，6.26），而妊娠下半年尿ETU浓度高与机率降低相关喘息的次数（OR = 0.50; 95％CI：0.26，0.96）。我们发现，在妊娠前半期高尿液ETU浓度与LRTIs之间的关联在后半期具有高或低ETU浓度的母子对之间持续存在。相反，当我们在上半年同时调整尿液ETU浓度时，妊娠下半年尿液ETU浓度高与喘息的相关性减弱。我们观察到怀孕期间测得的其他农药代谢物与呼吸道结局之间没有关联。

结论

我们的数据表明，妊娠上半年暴露于mancozeb / ETU可能与一岁后的呼吸系统结局有关。