ㄧ、台灣垃圾焚化廠周邊對新生兒不良出生結果之相關性探討二、Cotinine、基因多型性與嬰兒成長及神經行為發展

Abstract

Thesis 1. Adverse Birth Outcomes near Municipal Waste Incinerators in Taiwan Nowadays, the adverse influence of municipal waste incinerators on human health is both suspected and feared. Relevant studies are ongoing, especially in Taiwan, with its high densities of population and waste incinerators. Because there have been inconsistent conclusions on the reproductive health effects of waste incinerator emissions, we tried to investigate that the relationship between the exposure to waste incinerators and pregnancy outcomes such as preterm delivery, low birth weight, small for gestational age, and infant gender. Study areas were based on the research results of “ Health Risk Assessment on Incinerator-Emitted Dioxins in Taiwan”. The industrial source complex short-term model was used to determine the dioxins impact areas. A geographic information system was then used to plot the simulated results. All birth data would be linked from the birth registration database to do statistical analysis. We did not find any relationships between exposure to waste incinerators and adverse birth outcomes. Thesis 2. Cotinine, Genetic Polymorphism, and Infant Growth and Neurobehavioral Development More and more people emphasize that the women health effects of smoking and environmental tobacco smoke (ETS) exposure in recent years, especially the harm on pregnant women may affect their fetal, such as low birth weight (LBW). However, there are few studies about the association between smoking or ETS exposure among pregnant women and neurobehavioral development of their fetal. At present, associations between birth outcomes and smoking or ETS exposure have been investigated in many studies, however exposures to environmental and genetic factors in the etiology of adverse neurobehavioral development for infants are still not clear. We analyzed cotinine concentrations from maternal blood and umbilical cord blood, and evaluated the association among cotinine level, fetal growth, and neonate neurobehavioral development. In addition, we tried to understand the contribution from environmental exposure and genetic modification for the neurobehavioral development of neonate and children. Our study subjects were pregnant women and their neonates from the pilot of Taipei Birth Panel Study (TBPS) between April 2004 and January 2005, and a total of 328 maternal-newborn pairs. The cotinine concentrations of maternal bloods and umbilical cord bloods were analyzed with high-performance liquid chromatography coupled to tandem mass spectrometry (HPLC/MS/MS). For all neonates, neonatal neurobehavioral performance at two to five days after delivery is measured by Neonatal Neurobehavioral Examination in Chinese version (NNE-C). During six months of age, Infant/Toddler HOME of Home Observation for Measurement of the Environment Inventory (IT-HOME) and Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) were used to measure the performance of cognition and movement of infants. GSTT1, GSTM1and GSTP1 genetic polymorphisms were analyzed by polymerase chain reaction (PCR) method. Maternal smoking or ETS exposure during pregnancy negatively affects birth outcomes obviously, including birth weight, gestational age, birth length, and head circumference, and negatively affects neurobehavioral development, especially in motor performance. In addition, adverse effects of maternal smoking or ETS exposure on neurobehavioral development could be modified by metabolic genotypes, possibly by GSTT1, GSTM1, and GSTP1. There was a suggestive increase in risk for the newborn or maternal carrying more variant genotypes of GST1, GSTM1, and GSTP1.