孕中期母体血镍、砷水平与胎儿生长发育相关性研究

Correlation of Maternal Blood Levels of Nickel and Arsenic with Fetal Growth and Development in the Second Trimester

目的通过调查孕妇生活居住环境情况,了解母体血镍、砷水平对胎儿生长发育的影响,为阐明镍、砷对胎儿生长发育的影响提供依据。方法选择甘肃省某重金属污染地区及其毗邻、位于其上风侧的另一地区作为研究地区(污染区空气PM2.5中镍、砷水平高于对照区),通过问卷调查收集孕妇的基本情况,利用B型超声检测孕中期胎儿双顶径、头围、股骨长度、腹围、胎心率大小,采用电感耦合等离子质谱仪测定孕中期孕妇静脉血镍(Ni)、砷(As)水平。分别以对照区及污染区共计82名研究对象的母血镍、砷水平中位数为截点,将孕妇及宫内胎儿按孕妇静脉血镍、砷水平分为低、高金属暴露组。结果高砷暴露组来自于污染区的孕妇多于低砷暴露组(χ^(2)=14.07,P<0.01)。高镍组胎儿头围(201 mm)、腹围(168 mm)中位数低于低镍组头围(210 mm)和腹围(182 mm)(Z值分别为-2.53、-3.25;P<0.05);高砷组胎儿头围(204 mm)、股骨长度(38 mm)中位数小于低砷组头围(210 mm)和股骨长度(39 mm)(Z值分别为-2.03、-2.18;P<0.05)。胎儿头围、腹围与孕妇静脉血镍水平存在负相关关系(t值分别为-4.76、-5.45,P<0.05)。结论孕妇暴露于镍、砷污染的空气环境可以影响宫内胎儿的生长发育,孕中期孕妇静脉血镍含量与孕中期胎儿头围和腹围存在负相关。

Objective To investigate the living environment of pregnant women and the influence of maternal blood levels of nickel(Ni)and arsenic(As)on fetal growth and development,and to provide a basis for clarifying the influence of Ni and As on fetal growth and development.Methods A heavy metal-contaminated area in Gansu province,China and its adjacent area located upwind the contaminated areas were selected as study areas(Ni and As concentration in ambient PM2.5 at the contaminated area was higher than that at the control area),and a questionnaire survey was used to collect the basic information of pregnant women.Ultrasound was performed to measure biparietal diameter,head circumference,femur length,abdominal circumference,and fetal heart rate,and inductively coupled plasma-mass spectrometry was used to measure the levels of Ni and As in the venous blood of pregnant women in the second trimester.With the medians of blood Ni and As levels in 82 subjects in the control and contaminated areas as the cut-off values,the pregnant women and intrauterine fetuses were divided into low and high metal exposure groups according to the levels of Ni and As in the venous blood of pregnant women.Results Compared with the low As exposure group,the high As exposure group had a significantly higher proportion of pregnant women from the contaminated area(χ^(2)=14.07,P<0.01).Compared with the low Ni exposure group,the high Ni exposure group had significantly lower median head circumference(201 mm vs 210 mm,Z=-2.53,P<0.05)and median abdominal circumference(168 mm vs 182 mm,Z=-3.25,P<0.05);compared with the low As exposure group,the high As exposure group had significantly lower median head circumference(204 mm vs 210 mm,Z=-2.03,P<0.05)and median femur length(38 mm vs 39 mm,Z=-2.18,P<0.05).Fetal head circumference and abdominal circumference were negatively correlated with the level of Ni in the venous blood of pregnant women(t=-4.76 and-5.45,P<0.05).Conclusion Exposure to atmosphere with Ni and As pollution in pregnant women may affect the intrauterine fetal growth and development,and the level of Ni in the venous blood of pregnant women in the second trimester is negatively correlated with fetal head circumference and abdominal circumference.