妊娠期低水平铅暴露对婴儿神经心理发育的影响

The influence of low level lead exposure on nerves and mental development of infants in gestational period

目的:分析妊娠不同时期血铅水平与婴儿出生后神经心理发育的关系,评估出生前后低水平铅暴露对婴儿神经心理发育的影响。方法:随机抽取280例外来劳务工孕妇及所产婴儿为研究对象,测其孕早、中、晚期、分娩时血铅及脐带血铅水平;以孕中期血铅浓度第75百分位,分别构成相对高、低铅组,进行新生儿期及婴儿早期神经行为及心理发育比较,以婴儿神经心理发育水平为因变量进行多因素分析。结果:①相对高铅组新生儿行为神经评定(NBNA)总分低于低铅组,差异有统计学意义(P<0.05)。②低铅组婴儿智力发育指数(MDI)高于相对高铅组,差异有统计学意义(P<0.01);运动发育指数(PDI)低铅组高于相对高铅组5分,差异有统计学意义(P<0.05)。③婴儿早期神经心理发育水平与孕中期血铅水平和职业铅接触及被动吸烟呈负相关;与母教育程度、孕期喝奶量呈正相关。结论:预防妊娠母体铅暴露是防控子代铅毒性影响的关键措施。

Objective： To analyze the relationship between blood lead level in different stages of gestational period and nerves and mental development of infants after birth, then evaluate the influence of low level lead exposure on nerves and mental development in prior and postnatal birth. Methods： Randomly sampling 280 cases of external labor workers with pregnancy as objects of the study, blood lead level of early stage, middle stage, advanced stage pregnancy and umbilical cord were measured. According to the 75th percent of blood lead density of middle stage pregnancy, the objects were divided into high and low lead groups, then the nerves behavior and mental development of neonatal period and early stage of infant were compared between the two groups. And multiple factors analysis was carried out with nerves and mental development level of infants as dependent variable. Results： （1）NBNA total score in high lead group was significantly lower than the low lead group （P 〈 0. 05 ） . （2）MDI of infants in low lead group was significantly higher than the high lead group （P 〈 0. 01 ）, and PDI in low lead group was significantly higher than the high lead group （5 scores higher, P 〈 0. 05） . （3）Nerves and mental development level in early stage of infants were negative correlation with lead level of middle stage pregnancy, lead exposure of occupation and passive smoking, but positive correlation with education level of mothers and drinking milk volume of duration of pregnancy. Conclusion： Preventing lead exposure in gestational matrix is the key point of controlling the influence of filial generation saturnism.