围妊娠期暴露于空气污染物SO_2、NO_2与出生缺陷的相关性研究

Periconceptional Exposure to Air Pollutants SO_2,NO_2 Associated with Birth Defects

目的:采用流行病学方法分析天津市市内六区围妊娠期妇女空气污染物的暴露与出生缺陷的相关性。方法:收集天津市市内六区20家医院2001—2006年每月活产数及当月出生缺陷病例的详细信息。同期在同家医院按年龄配比随机选取正常妊娠活产的产妇作为对照,获取同期天津市环境监测中心市内六区国控测点常规污染物[二氧化硫(SO2),二氧化氮(NO2)]的月均浓度。利用病例-对照研究分析妊娠妇女在妊娠前及妊娠初3个月暴露于各种主要污染物中与出生缺陷发生之间的关系。结果:①生产先天性心脏病患儿产妇在妊娠前3个月及妊娠初3个月暴露NO2空气污染物浓度高于对照组(均P<0.05)。生产肢体短缩畸形患儿产妇妊娠前3个月及围妊娠期暴露于NO2空气污染物浓度高于对照组(均P<0.05)。生产多指或趾畸形患儿产妇妊娠前3个月暴露于NO2空气污染物浓度高于对照组(P<0.05)。②妊娠第1个月暴露于NO2是出生缺陷发生的危险因素。未发现妊娠前3个月及围妊娠期暴露于SO2与出生缺陷的发生有关。结论:妊娠妇女妊娠前3个月及妊娠早期暴露于较高浓度NO2可能与出生缺陷的发生有关。空气污染对人类胎儿的正常发育可能存在潜在威胁。

Objective：The aim of this study is to investigate the association between the exposure to air pollutions during maternal pregnancy and the risk of birth defects, nethods：A population-based case-control study was conducted to analysis the relationship between birth defects and air pollutants. The data of birth defects was collected from 20 hospitals in the six districts of Tianjin. The data used to be compared was also collected from the same hospitals during the same period. The data of the ambient pollutions was offered by Environmental Monitoring Centre of Tianjin （SO2, NO2）. The average density of the air pollutions per month was collected from January 2001 to December 2006 in the six districts of Tianjin. Results： （~fhe exposure air concentration of NO2 in mother delivery of congenital heart diseases in the 3 months before pregnancy and the first trimester is higher than that of the control group. ~）Exposure to NO2 during 3 months before pregnancy and periconceptional were positively correlated with limb shortening, while 3 months before pregnancy were positively correlated with multiple means or toe deformity. The concentration of NO2 in the first month of the pregnant will increase the risk of birth defect. There was no significant difference between air pollutant SO2 and birth defects. Conclusions：The concentration of NOz in 3 months before and after the pregnant will increase the risk of birth defect. Air pollution could have an adverse effect on normal fetal develop- ment in early pregnancy.