中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2013年
4期
200-205
,共6页
施淼%刘超斌%陈晓秋%宋岩峰%洪新如%孙庆华
施淼%劉超斌%陳曉鞦%宋巖峰%洪新如%孫慶華
시묘%류초빈%진효추%송암봉%홍신여%손경화
妊娠%颗粒物%空气污染物%胎儿%先天畸形%病例对照研究
妊娠%顆粒物%空氣汙染物%胎兒%先天畸形%病例對照研究
임신%과립물%공기오염물%태인%선천기형%병례대조연구
Pregnancy%Particulate matter%Air pollutants%Fetus%Congenital abnormalities%Case-control studies
目的 探讨妊娠早期大气可吸入颗粒物(inhalable particulate matter,PM10)暴露与胎儿畸形的关系. 方法 采用病例对照研究.收集2007年5月14日至2012年4月30日期间在南京军区福州总医院分娩或终止妊娠的203例胎儿畸形孕妇资料,针对胎儿不同畸形类型,在同时期(估计受孕日期相差＜30 d)的病例资料中,按照1∶2的比例随机抽取正常活产孕妇作为相应对照组.采用两配对样本t检验比较各畸形组与相应对照组妊娠第1、2、3个月和1～3个月PM10暴露的差异.采用Logistic回归分析孕妇年龄、孕次、产次及PM10暴露对胎儿心血管畸形的影响. 结果 根据病例组的入选和排除标准,纳入分析的畸形病例178例、对照组356例.其中心血管畸形胎儿72例,孕妇妊娠1～3个月PM10的暴露浓度高于144例对照组孕妇[(73.80±11.55)μg/m3与(70.49±10.83) μg/m3,t=2.066,P=0.040)],但2组孕妇妊娠第1、2、3个月PM10暴露浓度比较差异无统计学意义[(74.00±17.34) μg/m3与(71.70±15.39) μg/m3,t=0.992,P=0.322;(75.15±16.80) μg/m3与(71.38±15.66)μg/m3,t=1.625,P=0.106;(70.28±15.84)μg/m与(69.41±15.84) μg/m3,t=0.383,P=0.702].所有畸形胎儿、面颈部畸形胎儿及神经系统畸形胎儿孕妇与各自相应对照组孕妇妊娠早期PM10的暴露浓度差异无统计学意义(P均＞0.05).妊娠1～3个月PM10暴露浓度越高,胎儿心血管畸形的危险性越高.暴露浓度每增加1个四分位数,胎儿心血管畸形的危险性增加1.218倍(OR=2.218,95％CI:1.232～3.994,P=0.008).纳入孕妇年龄和孕产次的多因素配对Logistic回归分析显示,妊娠1～3个月PM10暴露浓度与胎儿心血管畸形呈显著正相关(OR=1.106,95％CI:1.035～1.183,P=0.003). 结论 妊娠早期PM110暴露对胎儿心血管畸形发生可能存在不良效应.
目的 探討妊娠早期大氣可吸入顆粒物(inhalable particulate matter,PM10)暴露與胎兒畸形的關繫. 方法 採用病例對照研究.收集2007年5月14日至2012年4月30日期間在南京軍區福州總醫院分娩或終止妊娠的203例胎兒畸形孕婦資料,針對胎兒不同畸形類型,在同時期(估計受孕日期相差＜30 d)的病例資料中,按照1∶2的比例隨機抽取正常活產孕婦作為相應對照組.採用兩配對樣本t檢驗比較各畸形組與相應對照組妊娠第1、2、3箇月和1～3箇月PM10暴露的差異.採用Logistic迴歸分析孕婦年齡、孕次、產次及PM10暴露對胎兒心血管畸形的影響. 結果 根據病例組的入選和排除標準,納入分析的畸形病例178例、對照組356例.其中心血管畸形胎兒72例,孕婦妊娠1～3箇月PM10的暴露濃度高于144例對照組孕婦[(73.80±11.55)μg/m3與(70.49±10.83) μg/m3,t=2.066,P=0.040)],但2組孕婦妊娠第1、2、3箇月PM10暴露濃度比較差異無統計學意義[(74.00±17.34) μg/m3與(71.70±15.39) μg/m3,t=0.992,P=0.322;(75.15±16.80) μg/m3與(71.38±15.66)μg/m3,t=1.625,P=0.106;(70.28±15.84)μg/m與(69.41±15.84) μg/m3,t=0.383,P=0.702].所有畸形胎兒、麵頸部畸形胎兒及神經繫統畸形胎兒孕婦與各自相應對照組孕婦妊娠早期PM10的暴露濃度差異無統計學意義(P均＞0.05).妊娠1～3箇月PM10暴露濃度越高,胎兒心血管畸形的危險性越高.暴露濃度每增加1箇四分位數,胎兒心血管畸形的危險性增加1.218倍(OR=2.218,95％CI:1.232～3.994,P=0.008).納入孕婦年齡和孕產次的多因素配對Logistic迴歸分析顯示,妊娠1～3箇月PM10暴露濃度與胎兒心血管畸形呈顯著正相關(OR=1.106,95％CI:1.035～1.183,P=0.003). 結論 妊娠早期PM110暴露對胎兒心血管畸形髮生可能存在不良效應.
목적 탐토임신조기대기가흡입과립물(inhalable particulate matter,PM10)폭로여태인기형적관계. 방법 채용병례대조연구.수집2007년5월14일지2012년4월30일기간재남경군구복주총의원분면혹종지임신적203례태인기형잉부자료,침대태인불동기형류형,재동시기(고계수잉일기상차＜30 d)적병례자료중,안조1∶2적비례수궤추취정상활산잉부작위상응대조조.채용량배대양본t검험비교각기형조여상응대조조임신제1、2、3개월화1～3개월PM10폭로적차이.채용Logistic회귀분석잉부년령、잉차、산차급PM10폭로대태인심혈관기형적영향. 결과 근거병례조적입선화배제표준,납입분석적기형병례178례、대조조356례.기중심혈관기형태인72례,잉부임신1～3개월PM10적폭로농도고우144례대조조잉부[(73.80±11.55)μg/m3여(70.49±10.83) μg/m3,t=2.066,P=0.040)],단2조잉부임신제1、2、3개월PM10폭로농도비교차이무통계학의의[(74.00±17.34) μg/m3여(71.70±15.39) μg/m3,t=0.992,P=0.322;(75.15±16.80) μg/m3여(71.38±15.66)μg/m3,t=1.625,P=0.106;(70.28±15.84)μg/m여(69.41±15.84) μg/m3,t=0.383,P=0.702].소유기형태인、면경부기형태인급신경계통기형태인잉부여각자상응대조조잉부임신조기PM10적폭로농도차이무통계학의의(P균＞0.05).임신1～3개월PM10폭로농도월고,태인심혈관기형적위험성월고.폭로농도매증가1개사분위수,태인심혈관기형적위험성증가1.218배(OR=2.218,95％CI:1.232～3.994,P=0.008).납입잉부년령화잉산차적다인소배대Logistic회귀분석현시,임신1～3개월PM10폭로농도여태인심혈관기형정현저정상관(OR=1.106,95％CI:1.035～1.183,P=0.003). 결론 임신조기PM110폭로대태인심혈관기형발생가능존재불량효응.
Objective To investigate the relationship between maternal exposure to airborne inhalable particulate matters (PM10) in the first trimester of pregnancy and the risk of fetal congenital deformity.Methods Relationship between exposure to airborne PM10 during the 1st,2nd,3rd and 1-3 months of gestation and the risk of fetal anomalies in 203 pregnant women with deformed fetuses,which paralleled to normal pregnant women with discrepancy of conception date ＜30 days (control),were retrospectively analyzed by a case-control study from May 14,2007 to April 30,2012 in Fujian Medical University and Fuzhou General Hospital.Multivariate Logistic regression adjusted for potential confounders including maternal age,gravidity and parity was performed for data analysis.Results According to the inclusion and exclusion criteria,178 pregnant women with deformed fetuses and 356 controlled cases were enrolled.The average levels of PM10 exposed in pregnant women Withfetal cardiovascular anomalies during 1-3 months of gestation were significantly higher than in the controls [(73.80±11.55) μg/m3 vs (70.49±10.83) μg/m3] (t=2.066,P=0.040),but PM10 exposure in the 1st,2nd and the 3rd month of pregnancy were comparable between the observed and control groups [(74.00±17.34) μg/m3 vs (71.70±15.39) μg/m3,t=0.992,P=0.322;(75.15±16.80) μg/m3 vs (71.38±15.66) μg/m3,t=1.625,P=0.106; (70.28±15.84) μg/m3 vs (69.41± 15.84) μg/m3,t=0.383,P=0.702].There were no significant differences of PM10 exposure levels when compared between facial-cervical anomalies,neurologic anomalies and total anomalies and their corresponding controls (P＞0.05).Each increased quartile of the PM10 exposure levels was associated with an elevated risk of fetal cardiovascular anomalies by 1.218 folds (OR =2.218,95 ％ CI:1.232-3.994,P=0.008).Paired multivariate Logistic regression analysis revealed,a positive correlation between PM10 levels at 1-3 months of gestation and fetal cardiovascular anomalies (OR =1.106,95％CI:1.035-1.183,P =0.003).Conclusions Maternal exposure to PM10 in the first trimester of pregnancy possibly exerts negative effects on fetal cardiovascular anomalies.
