农药接触与不良妊娠结局:中国农村地区的一项前瞻性队列研究

曲翌敏; 陈适; 李娟娟; 靳荣荣; 潘慧; 江宇

Abstract

曲翌敏,陈适,李娟娟,靳荣荣,潘慧,江宇.农药接触与不良妊娠结局:中国农村地区的一项前瞻性队列研究[J].Chinese journal of Epidemiology,2017,38(6):732-736

农药接触与不良妊娠结局:中国农村地区的一项前瞻性队列研究

Relationship between pesticide exposure and adverse pregnancy outcomes among reproductive couples in rural areas of China

Received:January 25, 2017

DOI：10.3760/cma.j.issn.0254-6450.2017.06.008

KeyWord: 农药接触不良妊娠结局队列研究

English Key Word: Pesticide exposure Adverse pregnancy outcomes Cohort study

FundProject:国家自然科学基金（81673184）；中国医学科学院创新基金（2016-I2M-1-008）

Author Name	Affiliation	E-mail
Qu Yimin	School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Chen Shi	Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Li Juanjuan	School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Jin Rongrong	School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Pan Hui	Department of Endocrinology, Key Lab of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Jiang Yu	School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China	jiangyu@pumc.edu.cn

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Abstract:

目的分析农药暴露情况与不良妊娠结局之间的关系。方法采用免费孕前优生健康检查项目2010年1月至2012年12月的数据进行统计分析。来自全国的248 501对计划在半年内怀孕的夫妻被纳入研究。通过问卷调查收集了夫妻怀孕前的农药接触情况以及妻子怀孕后的农药接触情况。妊娠结局通过医生填写记录。结果 248 501对参与夫妻中，有243 362对夫妻完成全部随访有妊娠结局且没有因为主观因素或意外导致流产或引产等，其中1 806位（0.74%）妻子在怀孕前有农药接触史，2 653位（1.09%）丈夫在妻子怀孕前有农药接触史，505位（0.21%）妻子在怀孕后接触过农药。母亲孕前农药接触是死胎死产（OR=3.37，95% CI：2.05～5.55）、异位妊娠（OR=3.17，95% CI：1.18～8.55）、低出生体重（OR=7.56， 95% CI：5.36～10.66）的危险因素。父亲单独农药接触与自然流产（OR=1.37，95% CI：1.03～1.80）显著相关，在父亲母亲均接触农药与低出生体重正相关（OR=3.65，95% CI：1.51～8.84），巨大儿负相关（OR=0.64，95% CI：0.44～0.93）。妊娠后农药接触是自然流产（OR=4.65，95% CI：3.47～6.24）的危险因素。其他不良妊娠结局包括早产、巨大儿等。结论农药接触是死胎死产、异位妊娠、低出生体重、自然流产等不良出生结局的危险因素。

English Abstract:

Objective To analyze the association between pesticide exposure and adverse pregnancy outcomes in women from the rural areas of China. Methods Data of "National Free Preconception Health Examination Project (NFPHEP)" from January 2010 to December 2012 was used for analysis. A total of 248 501 families that were planning to deliver a baby in the next 6 months were enrolled. Data on paternal exposure to pesticides before or during pregnancy was collected through questionnaires, with related outcomes on pregnancy recorded by doctors. Results Among all the 248 501 participants, 1 806 (0.74%) women and 2 653 (1.09%) men reported to have been exposed to pesticide before pregnancy, with 505 (0.21%) reported of having been exposed to pesticide during the period of pregnancy. Maternal exposure to pesticide was found a risk factor related to stillbirth (OR=3.37, 95%CI:2.05-5.55), peculiar smell pregnancy (OR=3.17, 95%CI:1.18-8.55) and low birth weight (OR=7.56, 95%CI:5.36-10.66). Paternal exposure to pesticide was also found related to miscarriage (OR=1.37, 95%CI:1.03-1.80), low birth weight (OR=3.65, 95%CI:1.51-8.84), or giant infant (OR=0.64, 95%CI:0.44-0.93). Maternal exposure to pesticide during pregnancy appeared a risk factor on miscarriage (OR=4.65, 95%CI:3.47-6.24). Other adverse outcomes on pregnancy would include premature birth and high birth weight. Conclusion Parental pesticide exposure appeared a risk factor on stillbirth, peculiar smell pregnancy, low birth weight and miscarriage.

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