脐血铅与初乳铅含量与新生儿神经行为发育关系(摘要)(英文)

The effect of lead levels in the umbilical cord blood and foremilk on the neurobehavioral development of the neonates

目的 探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系。方法 随机选取南京市妇幼保健院医院产科2010-01/04出生的足月新生儿170例。以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为(NBNA)发育评分作为效应指标,根据初乳铅中位数48.3μg/l,新生儿被分为高低铅两组。结果 高暴露组在新生儿主动肌张力、原始反射,和神经行为发育总评分上低于低暴露组,差异有统计学意义(P<0.05),在新生儿行为能力、被动肌张力、一般估价上差异无统计学意义。结论 初乳铅脐血铅水平和与婴儿的早期发育有关,铅可通过乳汁和脐血造成新生儿的铅接触,对新生儿婴儿早期神经行为发育产生不良影响。

Objective ： To explore the relationship of lead levels in umbilical cord blood and foremilk with the neurobehavioral development of neonates with intrauterine exposure to lead at low level. Methods ： Lead levels in umbilical cord blood, which could be determined as indicators for intrauterine exposure to lead, were determined for 170 randomly selected neonates delivered at Nanjing Maternity and Child Health Care Hospital. Neonatal behavioral neurological assessment （NBNA） total score were determined as effect index. A descriptive analysis was applied to evaluate their correlations. The effects of lead level in foremilk on neurobehavioral development of neonates and infans at the age of there months were analyzed, Lead level inforemilk was correlated with the neurobehaviotal development of infants at the age of three months. The neonates were divided into two groups of high - and low - exposure based on the cutoff foremilk lead values of 48.3 μg/l. Results ： There were significant differences in scores of NBNA and initiative muscle tension with P 〈 0.05 between the groups of high and low lead levels in umbilical cord blood, and the score of the primitive reflex showed difference with P 〈 0. 01, while no difference could be observed in the behavioral capability, passive muscle tension and general evaluation. Conclusion： The lead in the foremilk could transfer to the neonates, resulting in adverse effect on the early neurobehavioral development of neonates.