出生前后铅暴露对婴幼儿体格发育的影响

Effects of antenatal and postnatal lead exposure on infants physical development

目的了解环境铅污染区婴幼儿出生前后铅暴露对其体格发育的影响。方法采用前瞻性队列研究方法,在环境铅污染区建立新婚夫妇研究队列,并进行基线调查、孕前观察、孕期随访、分娩及新生儿情况记录,在子代婴幼儿期进行体格测量和跟踪问卷调查;分别采取相应时期血样用石墨炉原子吸收法测定血铅水平;纵向分析出生前后铅暴露对婴幼儿体格发育的影响。结果婴幼儿身高Z标准分在母亲基线血铅高、低2组间,胸围Z标准分在父、母亲基线血铅高、低2组间差异有统计学意义(P<0.05);24月以内的身高增长率,在父、母亲基线血和婴幼儿血3种血铅高、低2组间差异均有统计学意义(P<0.05)。不同血样的血铅水平与体格发育指标Z标准分和身高增长率均呈负相关。结论环境铅暴露导致的婴幼儿体格发育迟缓与出生后暴露和出生前宫内暴露有关,与父母亲体内基线铅负荷过高有关,防治铅对儿童的危害应在出生前就开始。

Objective To explore the effect of antenatal and postnatal lead exposure on infants physical development in lead polluting area. Methods Prospective cohort study was performed. The newly-wedding couples cohort was found in lead polluting area. Baseline investigation, pre-pregnacy observation, pregnant period foUow-up and labour and newborn baby record among them. When their offspring was infant period, physical examination were carried out. Meanwhile, blood were drawn and blood lead levels were measured with atomic absorption spectrophotometry. Results The difference of Z - standard score for infant height was significant between the high and low lead of mother baseline blood, Z - standard score for infant chest circumferenc in mother and father baselin blood. The difference of height growth rate within 24 months was significant between the high and low lead of mother and father baseline blood, umbilical cord blood. There were negative relation between blood lead levels and Z- standard score and height growth rate. Conclusion Infants physical development retard caused by lead exposure is associated with antenatal and postnatal exposure even baseline lead load in parent. Prevention of child lead poisoning should begin from antenatal .