Çocuklarda Konuşma Gecikmesi ile Plazma Ftalat Düzeyi Arasındaki İlişkinin İncelenmesi

Abstract

Speech delay is one of the most common developmental problems seen in preschool children. Therefore, being able to diagnose and identify underlying causes and risk factors is very important for timely intervention and prevention. When considering speech delay in children, possible biological, psychological, social and environmental factors should be examined and the problems should be discussed in detail. One of the risk factors of speech delay in prenatal and postnatal period is the exposure of mother and infant to environmental contaminants. This may cause a negative effect on the infant's neurological development and language development. One of the increasing environmental contaminants in daily life is phthalates, which are endocrine disrupting chemicals. In this study, we aimed to determine the relationship of phthalates with speech delay as a risk factor by comparing serum phthalate levels of children with isolated speech delay who have no underlying disease and healthy children of similar age. Children with isolated speech delay who admitted to the Developmental Pediatrics Outpatient Clinic of Hacettepe University İhsan Doğramacı Children's Hospital between October 2019 and February 2020 were included in the study group, and 40 healthy children of similar age were included in the control group. All children included in the study were surveyed to investigate risk factors for speech delay, phthalate exposure routes and frequency. Plasma di-(2-ethylhexyl) phthalate (DEHP) and dibutyl phthalate (DBP) levels were measured by high pressure liquid chromatography (HPLC). The median level of DEHP was 0.377 [0.003 - 1.224] µg / ml in the study group and 0.212 [0.007 - 1.112] µg / ml in the control group (p = 0.033). The DBP level was measured as median 0.395 [0.062 - 1.996] µg / ml in the study group and 0.270 [0.006 - 0.528] µg / ml in the control group (p = 0.004). Logistic regression analysis was used to analyze the association between the phthalate levels and factors affecting speech delay. While there was no significant difference between the study and control groups in terms of DEHP level (p=0.233), the DBP level was found significantly higher in the study group (p <0,001, β= - 0,525). In conclusion, the fact that phthalate levels are significantly higher in children with speech delay shows that these children are exposed to phthalate and it is thought that phthalates may play a role in the etiopathogenesis of speech delay.