尿砷水平与妊娠糖尿病发病风险及新生儿神经行为发育的相关性研究

Study on the relationship between urinary arsenic level and risk of gestational diabetes mellitus and neonatal neurobehavioral development

目的探讨尿砷水平与妊娠糖尿病(GDM)发病风险及新生儿神经行为发育的相关性。方法选取2020年3月至2021年3月河北省沧州中西医结合医院收治的GDM产妇35例作为研究对象,设为观察组(n=35);另同期选取35例于该院行健康孕检的正常产妇设置为对照组(n=35)。使用电感耦合等离子体质谱仪检测尿砷水平;使用新生儿神经行为发育评分(NBNA)量表评价新生儿神经行为发育情况。对比两组尿砷水平及新生儿行为能力、被动肌张力、主动肌张力、原始反射、一般行为等五项评分;分析尿砷水平与GDM发病风险的相关性及GDM母体尿砷水平与新生儿神经行为发育的关系。结果观察组产妇入院时尿砷水平为(48.36±7.42)μg/g,高于对照组(35.21±6.37)μg/g(P<0.05);观察组新生儿行为能力、被动肌张力、主动肌张力、一般行为评分分别为(10.34±1.25)分、(7.53±0.20)分、(5.24±0.13)分、(5.79±0.10)分,低于对照组的(11.21±1.02)分、(7.98±0.11)分、(7.58±0.59)分、(7.54±0.16)分(P<0.05)。Spearson相关分析显示,尿砷水平与孕早期、孕中期、孕晚期糖尿病发病风险呈正相关,GDM母体水平与新生儿行为能力、被动肌张能力、主动肌张能力、一般行为评分分别呈负相关;与新生儿原始反射无明显相关。结论尿砷水平与GDM发病风险密切相关,且GDM病母体尿砷水平与新生儿神经行为发育存在一定联系。

Objective To investigate the correlation between urinary arsenic level and the risk of gestational diabetes mellitus(GDM)and the neurobehavioral development of neonates.Methods From March 2020 to March 2021,35 women with GDM in Cangzhou Hospital of Integrated TCM-WM·Hebei were selected as the study group(n=35).In addition,35 normal parturients who underwent healthy pregnancy examination in our hospital were selected as the control group(n=35).Arsenic levels in urine were detected by inductively coupled plasma mass spectrometry.Neonatal neurobehavioral development score(NBNA)was used to evaluate the neurobehavioral development of neonates.Urine arsenic level and neonatal behavioral ability,passive muscle tension,active muscle tension,primitive reflex,general behavior scores were compared between the two groups.The correlation between urinary arsenic level and morbidity risk of GDM and the relationship between maternal urinary arsenic level and neonatal neurobehavioral development were analyzed.Results The urine arsenic level of postpartum women in the observation group at admission was(48.36±7.42)μg/g,higher than that of the control group(35.21±6.37)μg/g(P<0.05).The behavioral ability,passive muscle tone,active muscle tone,and general behavior scores of newborns in the observation group were(10.34±1.25)points,(7.53±0.20)points,(5.24±0.13)points,and(5.79±0.10)points,respectively,lower than those of the control group(11.21±0.02)points,(7.98±0.11)points,(7.58±0.59)points,and(7.54±0.16)points(P<0.05).Spearson correlation analysis showed a positive correlation between urinary arsenic level and the risk of diabetes in the first,second and third trimesters.The maternal level of GDM was negatively correlated with neonatal behavioral ability,passive muscle tension,active muscle tension and general behavioral score.There was no significant correlation with neonatal primitive reflex.Conclu⁃sion Urinary arsenic level is closely related to the risk of GDM,and there is a certain relationship between urinary arsenic level of GDM patients and neonatal neurobehavioral development.