双酚A与不明原因复发性流产发生关系的病例对照研究

Association of bisphenol A with unexplained recurrent spontaneous abortion: a case-control research

目的探讨环境主要污染物——类雌激素双酚A对女性复发性流产(胚胎停育)的影响。方法收集2014年10月至2016年4月第三军医大学西南医院妇产科门诊不明原因复发性流产或胚胎停育患者80例,选择80例正常妊娠妇女为对照组,使用固相萃取-同位素内标-高效液相色谱质谱联用法检测血清双酚A浓度,按年龄、体质量指数(BMI)、孕周、初潮年龄分组并进行比较,采用单因素和多因素非条件logistic回归模型分析双酚A与复发性流产发生的关联。结果病例组血清双酚A浓度高于对照组[39.51(19.72,57.13)vs 3.56(2.46,6.88)ng/m L,P<0.01];多因素logistic回归分析结果显示:双酚A是复发性流产的危险因素(OR=2.469)。两组间比较,双酚A浓度在年龄≤35岁、BMI、孕周、初潮年龄差异均有统计学意义(P<0.001)。结论双酚A可能与女性复发性流产(胚胎停育)有关。

Objective To investigate the effect of serum environment pollutant,bisphenol A,in the women with unexplained recurrent spontaneous abortion（ embryo damage）. Methods A case-control study was conducted in the outpatients of our gynecological department from October 2014 to April 2016. Eighty patients with unexplained recurrent spontaneous abortion（ embryo damage） were recruited,and 8 normal pregnant women were selected as controls. The isotope dilution-solid phase extraction（ SPE） and highperformance liquid chromatography-tandem mass spectrometry（ HPLC-MS/MS） were used to detect free bisphenol A in the serum. The levels of serum bisphenol A were compared according to the age,body mass index（ BMI）,gestation,and menarche age. Multiple factor non-conditional logistic regression analysis was adopted to analyze the relationship between bisphenol A and recurrent spontaneous abortion. Results The concentrations of unconjugated bisphenol A in the patients and controls were 39. 51（ 19. 72,57. 13） and 3. 56（ 2. 46,6. 88） ng/m L respectively（ P〈0. 01）. Multiple factor non-conditional logistic regression analysis showed that serum bisphenol A was one of the risk factors causing recurrent spontaneous abortion（ OR =2. 469）. Meantime,the bisphenol A concentration were significant different in age（ ≤35）,BMI,gestation and menarche age. Conclusion High level of bisphenol A might be associated with unexplained recurrent spontaneous abortion（ embryo damage）.