文章摘要
戚娟,梁春梅,严双琴,李志娟,李娟,黄锟,向海云,陶翊然,郝加虎,童世庐,陶芳标.铊暴露与出生结局的关联研究[J].中华流行病学杂志,2018,39(8):1112-1116
铊暴露与出生结局的关联研究
Study on the relationship of thallium exposure and outcomes of births
投稿时间:2018-03-06  
DOI:10.3760/cma.j.issn.0254-6450.2018.08.019
中文关键词: 孕妇;脐血;铊;出生结局
英文关键词: Pregnancy woman;Umbilical cord blood;Thallium;Birth outcomes
基金项目:国家重点研发计划(2016YFC1000204-2)
作者单位E-mail
戚娟 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系  
梁春梅 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系  
严双琴 243000 马鞍山市妇幼保健院  
李志娟 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系  
李娟 243000 马鞍山市妇幼保健院  
黄锟 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系  
向海云 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系  
陶翊然 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系  
郝加虎 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系  
童世庐 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系
200127 上海交通大学医学院儿童医学中心临床流行病学与生物统计研究室 
s.tong@qut.edu.au 
陶芳标 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系  
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中文摘要:
      目的 研究铊暴露与出生结局关联的相关性。方法 以2013年5月至2014年9月在马鞍山市妇幼保健院纳入的3 236名孕妇作为研究对象,采用电感耦合等离子质谱法检测孕妇外周血及新生儿脐血中的铊浓度,运用多元线性回归方法分析研究铊暴露与出生结局关联的相关性。结果 孕妇孕早、中期外周血和新生儿脐血中铊浓度分别为61.7(50.8~77.0)、60.3(50.8~75.2)和38.5(33.6~44.1)ng/L。调整混杂因素后,孕早期外周血铊浓度与新生儿出生头围呈负相关(β=-0.41,95%CI:-0.76~-0.06);脐血中铊浓度与新生儿出生身长呈负相关(β=-0.65,95%CI:-1.25~-0.05);而孕中期外周血铊浓度与新生儿出生体重、身长、头围均无统计学关联(P>0.05)。性别差异分析显示:孕早期外周血铊浓度与女婴出生头围呈负相关(β=-0.53,95%CI:-1.05~-0.01);脐血中铊浓度与女婴出生体重(β=-277.08,95%CI:-485.13~-69.03)、身长(β=-1.39,95%CI:-2.26~-0.53)呈负相关;孕早期和孕中期外周血及脐血中铊浓度与男婴出生体重、身长、头围均无统计学关联(P>0.05)。结论 铊暴露对新生儿出生结局的影响存在性别差异,孕早期外周血铊浓度与女婴出生头围呈负相关,脐血中铊浓度与女婴出生体重、身长均呈负相关。
英文摘要:
      Objective To investigate the relationship of thallium exposure and outcomes of births. Methods A total of 3 236 mothers who had visited in Ma'anshan Maternal and Child Health-Care Hospital between May 2013 and September 2014 were included in this study and their thallium concentrations measured from samples of maternal and umbilical cord blood by inductively coupled plasma mass spectrometry. The results were correlated and evaluated with birth outcomes of the infants, using the multiple linear regression method. Results The median (P25-P75) of thallium levels in first trimester, second trimester and umbilical cord blood were 61.7 (50.8-77.0), 60.3 (50.8-75.2) and 38.5 (33.6-44.1) ng/L, respectively. After adjustment for potential confounders, the thallium levels showed an inversely significant association with birth head circumference (unstandardized β coefficient=-0.41, 95%CI:-0.76--0.06) in the first trimester blood, and associated with reduced birth length (unstandardized β coefficient=-0.65, 95%CI:-1.25--0.05) in umbilical cord blood. However, there appeared no significantly associations with birth weight, length and head circumference (P>0.05) in second trimester. On stratification by sex, in girls but not in boys, the thallium levels were adversely associated with birth head circumference (unstandardized β coefficient=-0.53, 95%CI:-1.05--0.01) in the first trimester and were associated with decreased birth weight (unstandardized β coefficient=-277.08, 95%CI:-485.13--69.03) and length (unstandardized β coefficient=-1.39, 95%CI:-2.26--0.53) in umbilical cord blood thallium. Conclusions Thallium exposure appeared a gender difference in newborn birth outcomes. In the first trimester, it was negatively associated with the birth head circumference, in the umbilical cord blood, and reduced birth weight and length in girls.
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