In Utero Exposure to Manganese and Psychomotor Development at the Age of Six Months

出生前錳暴露與六個月大嬰兒之精神運動發展

10.7005/JOSH.200709.0204

蘇楓喬(Feng-Chiao Su)；廖華芳(Hua-Fang Liao)；黃耀輝(Yaw-Huei Hwang)；謝武勳(Wu-Shiun Hsieh)；吳惠琤(Hui-Chen Wu)；鄭素芳(Suh-Fang Jeng)；蘇怡寧(Yi-Ning Su)；陳保中(Pau-Chung Chen)

子宮內暴露 ； 錳 ； 精神運動發展 ； 兒童 ； In utero exposure ； Manganese ； Psychomotor development ； Children

勞工安全衛生研究季刊

15卷3期（2007 / 09 / 01）

204 - 217

英文

目的：評估在一般族群中，胎兒於出生前暴露到來自環境中的錳，會對其日後精神運動發展的影響。 方法：本研究為「Taiwan Birth Panel Study」的一部份，共有132對包含父母及其足月新生兒的研究對象，並在嬰兒6個月時至家中進行「嬰幼兒綜合發展測驗(Comprehensive Developmental Inventory for Infants and Toddlers，CDIIT)」的評量。此測驗是用來評估兒童在認知、語言、動作（含粗大動作及精細動作）、社會，與自助各方面的發展。臍帶血的錳濃度是以Agilent 7500C ICP-MS來分析。最後，利用複迴歸與校正平均數來探討錳暴露與精神運動發展間的關係。 結果：在CDIIT精細動作的部分，我們發現到錳濃度較高的組別其發展商數(developmental quotients)會較差(crude β=-7.0，SE=2.5)。但在校正後，此負相關性會略微下降(adjusted β=-6.0，SE=2.5)。再者，利用logistic regression分析後，也發現到與linear regression相同的結果(crude OR=3.20，95% CI=1.31-7.85；adjusted OR=3.02，95% CI=1.18-7.76)。此外，我們將錳濃度平均分為四組，進行校正平均數的分析，並發現到錳濃度與精細動作間呈現倒U字形的相關。 結論：研究中發現，即使是來自環境中的錳暴露，仍可能對胎兒造成精神運動發展上的不良影響，特別是在動作方面。然而，本研究尚有一些無法排除的干擾因子，為此，仍有待日後更進一步的研究來證實。不過，為避免胎兒有精神運動發展上的風險，仍建議懷孕婦女盡量避免暴露於過高的錳濃度之下。

Objective: We conducted the present study to evaluate associations between prenatal exposure to environmental manganese and psychomotor development in children from the general population in Taipei, Taiwan. Methods: The study is a part of the Taiwan Birth Panel Study. A total of 132 pairs of parents and their full-term babies were selected into this study. The Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) was conducted at the age of six months. The CDIIT was used to assess development in the areas of cognition, language, motor (including gross motor and fine motor), social, and self-help of children. Samples of cord blood were analyzed by an Agilent 7500C ICP-MS. Regression models and adjusted means were used to evaluate the association of exposure to manganese and psychomotor development. Results: The fine-motor developmental quotients (DQ) of the CDIIT were significantly influenced by the level of manganese (crude β=-7.0, SE=2.5); the reverse relationship, however, was slightly diminished after adjustment (adjusted β=-6.0, SE=2.5). Based on logistic regression models, the results corresponded with the linear regression models (crude OR=3.20, 95% CI=1.31-7.85; adjusted OR=3.02, 95% CI=1.18-7.76). In addition, the manganese concentration was separated by every 25% and analyzed though adjusted means. The relationship between manganese levels and fine-motor DQ showed an inverted U shape. Conclusion: Fetuses may be vulnerable to environmental manganese exposure, particularly in terms of motor performance at the early age of six months. Some confounding factors, however, could not be excluded. Thus, further research is necessary to verify our findings. Nonetheless, to prevent the risk of poorer psychomotor development, we advise pregnant women to avoid exposure to excessive manganese in ordinary life.

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