Prenatal Exposure to Endocrine Disruptors and Cardiometabolic Risk in Preschoolers: A Systematic Review Based on Cohort Studies

Background: Follow-up studies have reported both positive and negative associations between prenatal exposure to endocrine disrupting chemicals (EDCs) and some anthropometric indicators of overweight and obesity in children. However, few studies have evaluated the effect of this exposure on cardiometabolic risk factors in preschool-age children. The health and disease development paradigm (DOHaD) proposes that the physiological and metabolic adaptations triggered by the exposure to these compounds, coupled with postnatal conditions, can modify the risk of disease. In this context, cardiometabolic risk factors in children are not only an important outcome derived from prenatal exposure but a predictor/mediator of the children’s future health. Objective: To conduct a systematic review of the evidence published in the last 10 years from cohort studies on the association between prenatal exposure to EDCs and cardiometabolic risk factors in preschoolers. Design: Studies published from January 1, 2007 to May 1, 2017 in PubMed were analyzed. The research strategy was based on specified keywords and following the application of strict inclusion/exclusion criteria, 16 studies were identified and reviewed. Data were extracted and aspects of quality were assessed using an adapted Newcastle–Ottawa scale for cohort studies. Results: Only 5 of the 16 studies reviewed analyzed cardiometabolic risk factors in addition to anthropometric measures in children. The cohort studies included in this review suggest that prenatal exposure to low concentrations of EDCs has an impact on anthropometric variables and biochemical parameters in preschool-age children. Positive associations between prenatal exposure to EDCs and percentage of fat mass, body mass index, waist circumference, skinfolds and risk of overweight persisted after adjustment for important confounding variables. No association was found with lipid profile and glucose levels. Conclusions: Evidence was found to suggest that prenatal exposure to EDCs is positively associated with cardiometabolic risk factors in preschool children

Prenatal Exposure to Nitrogen Oxides and its Association with Birth Weight in a Cohort of Mexican Newborns from Morelos, Mexico

Background: The Child-Mother binomial is potentially susceptible to the toxic effects of pollutants because some chemicals interfere with placental transfer of nutrients, thus affecting fetal development, and create an increased the risk of low birth weight, prematurity and intrauterine growth restriction. Objective: To evaluate the impact of prenatal exposure to nitrogen oxides (NOx) on birth weight in a cohort of Mexican newborns. Methodology: We included 745 mother-child pair participants of the POSGRAD cohort study. Information on socio-demographic characteristics, obstetric history, health history and environmental exposure during pregnancy were readily available and the newborns’ anthropometric measurements were obtained at delivery. Prenatal NOx exposure assessment was evaluated using a Land-Use Regression predictive models considering local monitoring from 60 sites on the State of Morelos. The association between prenatal exposure to NOx and birth weight was estimated using a multivariate linear regression models. Results: The average birth weight was 3217 ± 439 g and the mean of NOx concentration was 21 ppb (Interquartile range, IQR = 6.95 ppb). After adjusting for maternal age and other confounders, a significant birthweight reduction was observed for each IQR of NOx increase (ß = −39.61 g, 95% CI: −77.00; −2.21; p = 0.04). Conclusions: Our results provides evidence that prenatal NOx exposure has a negative effect on birth weight, which may influence the growth and future development of the newborn.<p

Prevalencia de asma y otras enfermedades alérgicas en niños escolares de Ciudad Juárez, Chihuahua

Objetivo. Determinar la prevalencia y severidad del asma, de la rinitis y del eczema en escolares. Material y métodos. Estudio transversal efectuado entre abril de 1998 y mayo de 1999 en Ciudad Juárez, Chihuahua, México, a una muestra aleatoria de 6 174 niños de 53 escuelas. Se aplicó la metodología propuesta por el International Study of Asthma and Allergies in Childhood (ISAAC) (etapas 1 y 2) para determinar la prevalencia y severidad del asma, rinitis y eczema. La información de prevalencia, tanto actual como acumulada para dichos padecimientos, se obtuvo mediante un cuestionario ya estandarizado y contestado por los padres de los niños. El diseño de la muestra se hizo por un muestreo mixto, en el cual se estratificó por nivel de contaminación ambiental. Se estimaron prevalencias actual y acumulada estratificando por grupo de edad, sexo, área e historia familiar de asma. Resultados. La prevalencia acumulada de asma por diagnóstico médico y sibilancia (silbidos) fue de 6.8% (IC95% 6.2-7.4) y 20.% (IC95% 19.7-21.8), respectivamente; la prevalencia de sibilancia en los últimos 12 meses fue mayor en el grupo de 6-8 años que en el de 11-14 años(9.7%) contra 5.8% (p<0.01). La prevalencia de rinitis por diagnóstico médico fue de 5.0% (IC95% 4.5-5.6). La prevalencia de eczema por diagnóstico médico fue de 4.9% (IC95% 4.3-5.4). La prevalencia de síntomas de eczema en los últimos 12 meses fue de 12.7% en el grupo de 6-8 años y de 13.3% en el de 11-14 años. Los síntomas severos de asma fueron significativamente más prevalentes en el grupo de 6-8 años y en los meses de otoño. Conclusiones. La prevalencia de asma, tanto por diagnóstico médico como por síntomas, resulta relativamente baja en relación con otros estudios realizados con la misma metodología, pero las prevalencias de rinitis y eczema fueron altas. El texto completo en inglés de este artículo está disponible en: <A HREF="mailto:http://www.insp.mx/salud/index.html">http://www.insp.mx/salud/index.html</A

Effect of socioeconomic status on the association between air pollution and mortality in Bogota, Colombia

Objective. To evaluate the modification effect of socioeconomic status (SES) on the association between acute exposure to particulate matter less than 10 microns in aerodynamic diameter (PM10) and mortality in Bogota, Colombia. Materials and methods. A time-series ecological study was conducted (1998-2006). The localities of the cities were stratified using principal components analysis, creating three levels of aggregation that allowed for the evaluation of the impact of SES on the relationship between mortality and air pollution. Results. For all ages, the change in the mortality risk for all causes was 0.76% (95%CI 0.27-1.26) for SES I (low), 0.58% (95%CI 0.16-1.00) for SES II (mid) and -0.29% (95%CI -1.16-0.57) for SES III (high) per 10μg/m3 increment in the daily average of PM10 on day of death. Conclusions. The results suggest that SES significantly modifies the effect of environmental exposure to PM10 on mortality from all causes and respiratory causes

Effect of Personal Exposure to PM2.5 on Respiratory Health in a Mexican Panel of Patients with COPD

Background: Air pollution is a problem, especially in developing countries. We examined the association between personal exposure to particulate matter with an aerodynamic diameter less than 2.5 µm (PM2.5) on respiratory health in a group of adults with chronic obstructive pulmonary disease (COPD). Methods: All participants resided in Mexico City and during follow-up, personal exposure to PM2.5, respiratory symptoms, medications, and daily activity were registered daily. Peak expiratory flow (PEF) was measured twice daily, from February through December, 2000, in 29 adults with moderate, severe, and very severe COPD. PEF changes were estimated for each 10 µg/m3 increment of PM2.5, adjustment for severity of COPD, minimum temperature, and day of the sampling. Results: For a 10-µg/m3 increase in the daily average of a two-day personal exposure to PM2.5, there was a significant 33% increase in cough (95% CI, range, 5‒69%), and 23% in phlegm (95% CI, range, 2‒54%), a reduction of the PEF average in the morning of −1.4 L/min. (95% CI , range, −2.8 to −0.04), and at night of −3.0 L/min (95% CI, range, −5.7 to −0.3), respectively. Conclusions: Exposure to PM2.5 was associated with reductions in PEF and increased respiratory symptoms in adults with COPD. The PEF reduction was observed both at morning and at night

Consumo de alimentos y asma en niños escolares de Cuernavaca Food consumption and asthma in school children in Cuernavaca, Morelos, Mexico

OBJETIVO:Evaluar la relación entre la dieta y el desarrollo de asma y rinitis alérgica en escolares de Cuernavaca, Morelos, México. MATERIAL Y MÉTODOS: Se aplicó el cuestionario ISAAC (International Study of Asthma and Allergies in Childhood) a 5 460 niños de entre 6 a 8 y 11 a 14 años de edad, de nivel primaria, seleccionados de manera aleatoria. Se formaron seis grupos de alimentos a partir de un análisis de clusters jerárquico y se evaluó la relación con los padecimientos a través de modelos de regresión logística. RESULTADOS:El consumo de comida rápida tuvo un efecto adverso sobre la sibilancia actual (RM=1.82; IC95%=1.16-2.87) y el consumo de golosinas sobre más de tres episodios de sibilancia (RM=2.26; IC95%=1.04-4.95) y síntomas nasales sin gripa o catarro (RM=1.35; IC95%=1.06-1.71). CONCLUSIONES:Este estudio provee evidencia de que la dieta juega un papel muy importante, ya que el consumo abundante de comida rápida y golosinas incrementa el riesgo de asma y rinitis.<br>OBJECTIVE:To evaluate the relation between diet and the development of asthma and allergic rhinitis in schoolchildren from Cuernavaca, Morelos, Mexico. MATERIAL AND METHODS:We apply the ISAAC's questionnaire in 5460 schoolchildren from 6 to 8 and 11-14-year-old of elementary level selected in random form. Six groups of food were formed using a hierarchic clusters analysis and the association was evaluated using logistic regression models. RESULTS:The consumption of fast food had an adverse effect for current wheezing (OR=1.82; CI95%=1.16-2.87) and the consumption of tidbits for more than three episodes of wheezing (OR=2.26; CI95%=1.04-4.95) and nasal symptoms without cold, OR=1.35 (IC95%;1.06-1.71). CONCLUSIONS:This study provides evidence that the diet plays a very important role since the high consumption of fast food and tidbits increased the risk of asthma and rhinitis symptoms

Validez en el registro del pico espiratorio máximo de niños asmáticos de la Ciudad de México

Objetivo. Determinar la concordancia entre el pico espiratorio forzado (PEF) registrado por padres de niños asmáticos y el PEF electrónico que es el almacenado en el AirWatch (PEFe). Material y métodos. Se obtuvo el PEF de 42 niños de 5 a 15 años de edad del Hospital Infantil de México Federico Gómez de la Ciudad de México entre octubre de 1998 y 1999. Los padres registraron el valor máximo del PEF en un diario de salud. Se calculó la correlación de Spearman entre el PEFe y el PEFr. Utilizamos un modelo logístico de efectos mixtos. Resultados. La correlación del PEFe y el PEFr fue r= 0.96 (p<0.05) en niños con diagnóstico de asma moderada o severa y r= 0.40 (p< 0.05) en niños con asma leve. El tiempo de seguimiento y severidad del asma, el género y edad del niño y sus interacciones eran predictores de las diferencias entre el PEFe y el PEFr. Conclusiones. Los padres de niños de 6 a 8 años con asma moderada o severa reportan mejor el PEF en el diario de salud a lo largo del seguimiento que los padres de otros grupos

Validez en el registro del pico espiratorio máximo de niños asmáticos de la Ciudad de México Validity of peak flow record in asthmatic children residing in Mexico City

OBJETIVO: Determinar la concordancia entre el pico espiratorio forzado (PEF) registrado por padres de niños asmáticos y el PEF electrónico que es el almacenado en el AirWatch (PEFe). MATERIAL Y MÉTODOS: Se obtuvo el PEF de 42 niños de 5 a 15 años de edad del Hospital Infantil de México Federico Gómez de la Ciudad de México entre octubre de 1998 y 1999. Los padres registraron el valor máximo del PEF en un diario de salud. Se calculó la correlación de Spearman entre el PEFe y el PEFr. Utilizamos un modelo logístico de efectos mixtos. RESULTADOS: La correlación del PEFe y el PEFr fue r= 0.96 (p<0.05) en niños con diagnóstico de asma moderada o severa y r= 0.40 (p< 0.05) en niños con asma leve. El tiempo de seguimiento y severidad del asma, el género y edad del niño y sus interacciones eran predictores de las diferencias entre el PEFe y el PEFr. CONCLUSIONES: Los padres de niños de 6 a 8 años con asma moderada o severa reportan mejor el PEF en el diario de salud a lo largo del seguimiento que los padres de otros grupos.<br>OBJECTIVE: To determine the concordance between maximum peak expiratory flow records (PEFr) reported by the parents of asthmatic children and the electronic values stored by the AirWatch device (PEFe). MATERIAL AND METHODS: Records of PEF measurements between October 1998 and 1999 were obtained from 42 asthmatic children 5 to 15 years of age recruited at the Hospital Infantil de Mexico Federico Gomez, in Mexico City. Parents recorded the maximum value in the health diary. Spearman correlation was calculated between PEFe and PEFr and a mixed-effects logistic model was used. RESULTS: The correlation between PEFe and PEFr was r=0.96 (p<0.05) among children with a diagnosis of moderate or severe asthma and r=0.40 (p<0.05) among children diagnosed with mild asthma. Follow-up time, asthma severity, gender and age of the child and their interactions were predictors of the differences between PEFe and PEFr. CONCLUSIONS: Parents of children with moderate or severe asthma from 6 to 8 years of age report PEF values with greater accuracy during follow-up than others