环境镉暴露对妊娠结局和胎儿生长发育的影响

Effect of environmental exposure to cadmium on pregnancy outcome and fetal growth

目的 评价环境镉暴露对妊娠结局和胎儿生长发育的可能影响。方法 于 2 0 0 2年 11月～ 2 0 0 3年 1月选择湖北省大冶市镉污染地区和对照地区的待产孕妇 ,进行问卷调查和体格检查。同时采集孕妇静脉血、脐带血和胎盘标本测定镉含量。比较镉污染地区和对照地区早产发生率、新生儿窒息发生率、新生儿出生身长和体重差异有无显著性。结果 镉污染地区早产发生率为 2 0 8% ,新生儿窒息发生率为 2 9 2 % ;对照地区分别为 10 0 %和 15 0 % ,两者间差异无显著性。污染地区新生儿出生身长为 ( 4 7 88± 4 15 )cm ,低于对照地区 ( 5 0 65± 2 41)cm (P <0 0 1)。多因素线性回归分析表明 ,脐血镉水平与新生儿出生身长呈显著负相关。结论 环境镉暴露可以显著降低新生儿出生身长。

Objective To evaluate the potential effect of environmental exposure to cadmium on pregnancy outcome and fetal growth.Method Pregnant women were selected from cadmium-polluted area and control area at Daye City in Hubei Province between November2002and January2003,the data such as their age,gestational age,pregnancy history,and life style etc.were obtained from questionnaire interview.The gravidas were examined for height and weight before delivery,and the newborns were examined for Apgar score,birth height and birth weight;the whole blood of gravidas,the cord blood and the placenta were collected for the detec-tion of cadmium levels by inductively coupled plasma emission mass spectroscopy.The incidences of premature birth(gestational age≤37weeks),neonatal asphyxia,birth height and weight of neonates were compared between gravidas from cadmium-polluted area and control area.Result The incidences of premature birth and neonatal asphyxia in the gravidas from cadmium-polluted area were20.8%and29.2%respectively,which were10.0%and15.0%respectively in the gravidas from control area but there was no significant dif-ference between those two groups.While the birth height of neonates from cadmium-polluted area(47.88±4.15)cm was lower than that of control area(50.65±2.41)cm,(P<0.01).Multiple linear regressions analysis indicated that cord blood cadmium level was significantly negatively associated with birth height.Each log-increase of cadmium level in cord blood was associated with2.10cm de-crease in birth height of neonate.Conclusion Environmental exposure to cadmium could significantly lower neonatal birth height.