妊娠期高血压孕妇血清铅水平对早产及小于胎龄儿发生的影响

Effect of Serum Lead Level on Preterm Birth and Small for Gestational Age in Pregnant Women with Gestational Hypertension

目的:探究妊娠期高血压孕妇血清铅水平对早产及小于胎龄儿(SGA)发生的影响。方法:于2017年1月-2020年1月招募2128例妊娠高血压孕妇为研究对象,对入组孕妇的血清铅含量进行测定,按照其血清铅水平将其分为低血清铅水平组(L-Pb组,n=877)、中血清铅水平组(M-Pb组,n=762)和高血清铅水平组(H-Pb组,n=489),比较不同组别孕妇和新生儿的特征、早产以及SGA发生情况,探究孕妇血清铅水平与早产、SGA风险之间的关系。结果:H-Pb组新生儿的出生体重明显低于L-Pb组与M-Pb组(P<0.05);三组新生儿的出生身长、头围、胸围比较,差异均无统计学意义(P>0.05)。三组早产和SGA发生率比较,差异均有统计学意义(P<0.05);且三组中期早产发生率比较,差异有统计学意义(P<0.05)。三组不同性别婴儿SGA发生率比较,差异均有统计学意义(P<0.05)。结论:孕妇暴露于高血清铅水平下会更易出现中期早产和SGA,妊娠期高血压孕妇应着重注意做好防护。

Objective:To investigate the influence of serum lead level on the occurrence of premature birth and small for gestational age(SGA)in pregnant women with hypertension during pregnancy.Method:From January 2017 to January 2020,2128 pregnant women with high blood pressure were recruited as the study object,the serum lead content of the pregnant women were determined.According to the serum lead level,they were divided into low serum lead level group(L-Pb group,n=877),middle serum lead level group(M-Pb group,n=762)and high serum lead level group(H-Pb group,n=489).The characteristics,premature birth and SGA incidence of different groups of pregnant women and newborns were compared,and the relationship between serum lead level and risk of premature delivery and SGA was studied.Result:The birth weight of neonates in H-Pb group was significantly lower than that in L-PB group and M-Pb group(P<0.05).There were no significant differences in birth body length,head circumference and chest circumference among the three groups(P>0.05).Comparison of the incidence of premature birth and SGA among the three groups,the differences were statistically significant(P<0.05).Comparison of the incidence of mid-term premature birth among the three groups,the difference was statistically significant(P<0.05).Comparison of the incidence of SGA in three groups of infants of different genders,the differences were statistically significant(P<0.05).Conclusion:Pregnant women exposed to high serum lead levels are more likely to have mid-term preterm labor and SGA.Pregnant women with hypertension during pregnancy should pay more attention to protection.