重金属暴露对不同妊娠阶段胎儿发育的影响

Impact of exposure to heavy metal on fetal development in different stages of pregnancy

目的研究正常妊娠的不同妊娠阶段孕妇血液中重金属暴露水平的动态变化及胎儿畸形情况,探讨不同妊娠阶段孕妇血液中各重金属水平变化对胎儿发育的影响。方法选择2017年1月-2018年2月在菏泽市某综合性医院进行健康检查的466名健康孕妇为研究对象,采用电感耦合等离子体-质谱法(ICP-MS)测定不同妊娠阶段的孕妇血液中铅、镉、锰、砷的浓度,彩色多普勒数字超声检测仪诊断胎儿畸形。结果不同妊娠期孕妇血铅、血镉、血锰、血砷4种重金属的含量差异均有统计学意义(均P<0.05);观察组和对照组妊娠中期血铅和血镉的含量差异均有统计学意义(均P<0.05);全部孕妇中27例(5.79%)发生胎儿畸形,其中妊娠中期发生率最高为3.64%(17例)。结论菏泽地区不同妊娠阶段的非职业暴露孕妇血液中的重金属水平各不相同,妊娠中期血铅和血镉的含量对胎儿出现畸形有显著影响。

Objective To study the dynamic changes of exposure to heavy metal in maternal blood and the occurrence of fetal malformation in different stages of pregnancy in normal pregnancy,explore the impact of the change of the heavy metal in maternal blood on fetal development in different stages of pregnancy.Methods A total of 466 healthy pregnant women were selected as the study subjects,who underwent physical examination in a general hospital in Heze City during January 2017 to February 2018.The concentrations of lead,cadmium,manganese and arsenic in blood samples of pregnant women at different stages of pregnancy were determined with inductively coupled plasma mass spectrometry(ICP-MS),and the diagnosis of fetal malformation were made with color Doppler ultrasonic detector.Results There were statistically significant differences in the contents of heavy metal such as blood lead,cadmium,manganese and arsenic during the different stages of pregnancy(all P<0.05).There were statistically significant differences in the contents of blood lead and cadmium between observation group and control group in the second trimester of pregnancy(both P<0.05).Among all pregnant women,the fetal malformation occurred in 27(5.79%)cases,and 17(3.64%)cases were found during the second trimester.Conclusion The levels of heavy metals in the blood of pregnant women with non-occupational exposure at different stages of pregnancy in Heze area are different.The content of blood lead and cadmium in the second trimester of pregnancy has a significant effect on fetal malformation.