妇女孕期化肥暴露与子代高出生体重发生风险关系

A study of association between risks of high birth weight and maternal chemical fertilizer exposure

目的:探索北方农村地区妇女孕期化肥暴露与其子代高出生体重(HBW)发生风险之间的关联。方法:在2007-2012年山西省平定县出生人口监测系统中妊娠时间≥37周、出生体重≥4000g的新生儿中随机选取296例新生儿作为HBW病例进行随访,并将病例分为≥4000~<4200g HBW组(171例)和≥4200 g HBW组(125例);随机选择204例妊娠≥37周,出生体重≥2500~<4000 g的健康新生儿作为对照。根据妇女居住村庄村级化肥年施用量及妇女所在家庭化肥年施用量衡量妇女孕期化肥暴露。采用分层多因素Logistic回归分析探索妇女孕期化肥暴露与HBW发生风险的关联。结果:调整混杂因素后,≥4000~<4200 g HBW组孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是村级年化肥施用量<50吨妇女的2.46倍(95%CI 1.02~5.95);合并的HBW组病例对照的分层多因素logistic回归结果显示,调整了混杂因素后,孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是暴露于村级年化肥施用量<50吨妇女的2.16倍(95%CI 1.05~4.44)。结论:北方农村地区妇女孕期暴露于化肥施用可能是高出生体重的危险因素,建议妇女孕期尽量避免化肥施用暴露。

Objective:To explore the association between the risk of high birth weight(HBW)and maternal chemical fertilizer exposure during pregnancy in rural areas of the north of china.Methods:Data of the newborns in this study were from a surveillance system of birth population in Pingding county,Shanxi Province between 2007 and 2012.296 newborns whose birth weight exceeded 4000g from the system were randomly selected in group A and were followed up,and they were divided into group A1(125 cases with birth weight≥4200g)and group A2(171 cases with birth weight≥4000~<4200g).And the health newborns with birth weight between 2500g and 4000g were randomly chosen from the system,and were included in control group.Chemical fertilizer exposure was measured by the chemical fertilizer usage at village level and family level.And multi-level and multi-factor analysis was performed to explore the potential chemical fertilizer exposure risks relative to HBW.Results:In the group A2,after adjusting confounding factors,the risk of HBW of women with annual chemical fertilizer usage≥100 tons were 2.54(95%CI:1.02-5.95)times higher than that of women with the usage<50 tons.In group A,after adjusting confounders,multi-level and multi-factor Logistic regression results showed that the risk of HBW of women with annual chemical fertilizer usage≥100 tons were 2.16(95%CI:1.05-4.44)times higher than that of women with the usage<50 tons.Conclusion:The risk of HBW was associated with maternal chemical fertilizer exposure during pregnancy.It's suggested that pregnant women should try to avoid their chemical fertilizer exposure.