孕妇发砷含量及相关因素与新生儿先天性心脏病的关系研究

Relation between pregnant women hair arsenic and its related factors and neonatal congenital heart disease

目的探讨孕妇头发砷含量及其相关影响因素与新生儿先天性心脏病(CHD)的关系,为临床预防胎儿CHD提供参考依据。方法选取本院2012年1月至2014年1月收治的确诊为胎儿CHD的孕妇50例作病例组,再选取50例本院同期收治的健康孕妇作为对照组。应用电感耦合等离子质谱法测定两组患者头发中砷含量,并对患者进行问卷调查,分析胎儿CHD与孕妇发砷含量及其他相关因素的关系。结果病例组与对照组孕妇发砷含量差异具有统计学意义(P<0.05);复杂型CHD孕妇的发砷含量显著高于简单型CHD孕妇(P<0.05),与是否合并心外畸形无显著相关(P>0.05);相关因素分析结果显示,孕妇发砷含量、孕妇接触有毒物质及化学物质、丈夫吸烟、孕妇饮酒5个因素与胎儿CHD显著相关(P<0.05)。结论孕妇发砷含量增高以及接触化学物质、有毒物质、有饮酒习惯、丈夫吸烟等因素均可能导致胎儿CHD的发生。

Objective To investigate the relation between neonatal congenital heart disease and pregnant women hair arsenic and its related factors,to provide reference for clinical prevention of fetal congenital heart disease（ CHD）. Methods Fifty pregnant women received treatment by the diagnosis of fetal congenital heart disease were selected as case groups from January 2012 to January 2014,then 50 cases of healthy pregnant women received treatment in the same period were selected as control group. Hair arsenic contents of the two groups were detected by the inductively coupled plasma mass spectrometry determination; questionnaire survey of patients was conducted to analyze the relationship between fetal congenital heart disease and pregnant women hair arsenic and other related factors. Results Differences in hair arsenic contents of pregnant women of the two groups statistically significant（ P 〈0. 05）; hair arsenic contents of complex CHD pregnant women was significantly higher than that of simple CHD pregnant women（ P 〈0. 05）,but had no significant correlation with heart malformations（ P 〉0. 05）; Related factors analysis showed the fetal CHD had significant relation with according to the hair arsenic contents,toxic substance and chemicals exposure,husband smoking and alcohol drinking of pregnant women（ P 〈0. 05）. Conclusion Increased arsenic contents,toxic substance and chemicals exposure,husband smoking and drinking habits of pregnant women would lead to fetal CHD occurrence.