孕中期低水平铅暴露对新生儿神经行为发育的影响

The Effects of Low Level Lead Exposure of Pregnancy to Neuro-Behavioral Development of Neonates.

【目的】 观察孕中期低水平铅暴露对新生儿神经行为发育的影响。 【方法】 采用配对方法对 94例检测了孕中期血铅水平的产妇所生新生儿进行了新生儿 2 0项行为神经发育评分 (NABA) ,并与其母亲的孕中期血铅水平及脐血铅水平 (6 8例 )进行相关分析 ;以孕中期妇女血铅水平 0 .2 4 μmol/L、0 .30 μmol/L、0 .36 μmol/L及其脐血铅水平 0 .15 μmol/ L、0 .2 1μmol/L、0 .2 6 μmol/L(分别为P2 5、P50 、P75)为分界点 ,分为相对高铅组及低铅组 ,进行t检验。 【结果】 新生儿神经行为发育的总得分、行为能力、主动肌张力与孕中期妇女的血铅水平呈显著的负相关关系、相关系数分别为 0 .5 2 9(P <0 .0 1)、 0 .4 0 2 (P <0 .0 1)和 0 .2 5 3(P <0 .0 5 ) ;新生儿神经行为发育的总得分、行为能力与脐血铅水平有显著的负相关关系。相关系数分别为 0 .4 0 9(P <0 .0 1)和 0 .4 17(P <0 .0 1) ;孕中期血铅在 0 .30 μmol/L的水平、脐血铅在 0 .2 1μmol/L的水平 ,即在P50 分界点 ,两组的总分即有差异。 【结论】 孕妇孕中期的铅暴露即使在 0 .30 μmol/L的水平也可能对胎儿期的发育构成危害 。

To explore the effects of low level Pb 2+ exposure during pregnancy on neuro behavioral development of neonates. Ninty four neonates were selected and their mother's blood Pb 2+ levels in pregnant in second trimester were determined.The neuro behavioral cognitive performance of neonates were evaluated by Neonatal Behavioral Neurological Assessment(NABA).Sixty eight umbilical blood Pb 2+ levels were determined by atomic absorption spectrometer and the neuro behavioral cognitive performance of neonates were evaluated.Related analysis were made with blood lead level and neuro behavioral development scores with pregnancy, by the Pb 2+ lead levels of 0.24μmol/L,0.30μmol/L,0.36μmol/L and umbilical blood Pb 2+ levels of 0.15μmol/L,0.21μmol/L,0.26μmol/L as cutoff values,they were divided into high and low blood Pb 2+ level groups and t test were made. There was a significant negative relationship between the pregnancy blood Pb 2+ level and NABA behavioral ability and Active muscle tension.There was a significant negative relationship between the umbilical cord blood Pb 2+ level and NABA and behavioral ability. With pregnarly blood Pb 2+ level of 0.30μmol/L and umbilical blood Pb 2+ level of 0.21μmol/L as cutoff values.There were a significant difference in NABA between high and low blood Pb 2+ levels groups. With pregnant in second trimester blood Pb 2+ level of 0.36 μmol/L and umbilical blood Pb 2+ level of 0.26 μmol/L as cutoff values. There were a very significant difference in NANB and behavioral ability between high and low blood Pb 2+ level groups. [Conclusions] Lower level Pb 2+ exposure (0.30μmol/L) during pregnancy can have harmful effects on fetus development and can alsocause adverse effects on neonatal neuro behaviroal development.