妊娠期非职业性低水平重金属暴露与新生儿生长发育关系的初步研究

Effects of non-occupational low-level heavy metals exposure in pregnancy on fetal growth and development

目的研究妊娠期非职业性低水平重金属暴露与新生儿生长发育关系。方法选择2012年3月至2013年5月在江苏中部某电镀工业区3家医院分娩的209例孕妇及其208例新生儿作为研究对象,对基本情况进行问卷调查,并测定孕妇尿、静脉全血和新生儿脐带血中的镉、铅、硒含量及新生儿体重、身长。结果孕妇尿、静脉全血和新生儿脐带血中镉、铅、硒含量中位数分别为0.10、0.66、5.07μg/g Cr,0.48、40.51、131.48μg/L,0.15、32.30、126.33μg/L。尿镉均低于GB/T17221—1998《环境镉污染所致健康危害区标准》限值(15μg/g Cr)。经Wilcoxon配对秩和检验,孕妇血镉、铅、硒的含量均高于新生儿脐带血(P<0.01);各有8例孕妇血和脐带血铅高于100μg/L,分别占3.83%和3.85%;孕妇血与新生儿脐带血镉、铅、硒含量均呈正相关(P<0.01,P<0.05)。经多重逐步回归分析,新生儿出生体重与孕妇血镉的自然对数值呈负相关(P<0.05),而与脐带血硒的自然对数值呈正相关(P<0.05)。结论本次调查中孕妇和新生儿的血镉、血铅暴露水平较低。孕妇血与新生儿脐带血中镉、铅、硒含量存在相关性,孕妇镉暴露可能影响新生儿出生体重,硒的摄入可能有利于新生儿的生长发育。

Objective To explore the effect of non-occupational low-level heavy metals exposure in pregnancy on fetal growth and development. Methods A total of 209 pregnant women and 208 infants were chosen as the study subjects between March, 2012 and May,2013 in three hospitals of a city of Jiangsu province, informed consent questionnaires were performed ,the maternal urine, blood and cord blood samples were measured with inductively coupled plasma mass spectrometry （ICP-MS）,and the birth weight and height of newborns were measured. Results The median of cadmium, lead and selenium in maternal urine, blood and cord blood was 0.10,0.66,5.07 μg/g Cr,0.48,40.51,131.48 μg/L and 0.15,32.30,126.33 μg/L respectively. The cadmium concentrations in the maternal urine were lower than 15 μg/g Cr of the Discriminant Standard for Health Hazard Area Caused by Environmental Cadmium Pollution （GB/T 17221-1998）. The results of the Wilcoxon test showed that the concentrations of cadmium, lead and selenium in the maternal blood were significantly higher than the concentrations of these metals in cord blood （P〈0.01）. The lead concentrations in 8 maternal blood samples （3.83%） and 8 cord blood samples （3.85%） were higher than 100 μg/L. Maternal blood cadmium,lead,selenium exposure levels were correlated positively with their umbilical cord blood concentrations （P〈0.01, P〈0.05）. Stepwise regression analysis indicated that newborn birth weight was negatively correlated with maternal blood cadmium （P〈0.05）, and Positively with cord blood selenium（P〈0.05）. Conclusion The exposure of the cadmium and lead in maternal and cord blood in this investigation is lower. Maternal cadmium, lead, selenium exposure levels correlated with their umbilical cord concentrations, and maternal cadmium exposure may affect the newborn birth weight. Selenium supplement may be benefit for fetal growth.