温室作业女性人群农药暴露对妊娠结局的影响

Effects of pesticide exposure in greenhouse on pregnancy outcome

目的了解温室作业女性人群长期农药暴露对妊娠结局的影响。方法随机抽取2010年3月—2014年12月在潍坊市妇幼保健院等3家单位妇产科生育住院的产妇为研究对象,其中在孕前及孕期累计且连续从事温室作业至少2年以上者449人为暴露组,不从事温室作业且不接触农药的同医院产妇152人为对照组。通过问卷调查和查阅资料等方式获得女性农药暴露情况、既往生育史、妊娠期疾患、妊娠结局等;并根据农药暴露强度将暴露组分为低、中、高暴露组,统计各组不良妊娠结局发生情况。结果调查人群的不良妊娠结局共166例,发生率为18.53%(166/896);其中年龄>35岁者不良妊娠结局发生率为31.25%(45/144);有异常孕产史者不良妊娠结局发生率为47.83%(11/23),温室作业产妇的不良妊娠结局发生率为21.21%(140/660)。不同农药暴露量的产妇早产、自然流产、死胎及死产、出生缺陷发生率差异有统计学意义(P<0.05),均随暴露量的增加而升高。结论温室作业女性人群长期农药暴露可能导致早产、流产、死胎及死产、出生缺陷等不良妊娠结局。

Objectlve To explore effects of long-term multiple pesticides exposure in the greenhouse on pregnancy outcome. Methods The delivery women in the department of obstetrics and gynecology were randomly selected from three hospitals in Weifang, Shandong province during the period from March, 2010 to December, 2014 among them, 449 farmers who had been continually working more than two years in greenhouse during progestation and gestation were selected as the exposure group, and 152 delivery women who didn＇t contact pesticide and engage in greenhouse were selected as the control group. The information about women farmers who were engaged in vegetable greenhouses was collected through questionnaire survey and look up data. The information acquired included the situation of pesticide exposure, previous reproductive history, pregnancy disorders, pregnancy outcome and so on. According to the cumulative pesticide exposure index, the exposure group was divided into low, media and high exposure group. Results A total of 166 cases had adverse pregnancy outcomes, the incidence was 18.53%. Among them, the incidence was 31.25% in the group who were older more than 35, 47.83% in the group of the pregnant women with abnormal pregnancy history, 21.21% in the greenhouse workers. The incidence of premature group, spontaneous abortion, stillbirth, birth defects were statistically significant among the three exposed groups. Altogether, there were statistically significant between the high exposure group and the control group. Conclusion Long-term pesticide exposure during progestation and gestation can induce adverse pregnancy outcome, such as premature birth, spontaneous abortion, stillbirth, birth defects and so on.