环境重金属内暴露与既往不良妊娠结局的相关性研究

Association between internal exposure to heavy metals and history of adverse pregnancy outcoms

目的探讨广西河池地区环境重金属内暴露与既往不良妊娠结局的关系。方法于2013—2014年在广西河池长老乡5个村抽取180名有妊娠史的成年女性,按照是否有既往不良妊娠结局分为不良妊娠组与对照组,以电感耦合等离子质谱法(ICP-MS)检测全血中铅、镉、砷、铬水平。以多因素logistic回归分析环境重金属内暴露与既往不良妊娠结局的关系。结果不良妊娠组血Pb几何均值(41.86μg/L)明显高于正常女性(30.48μg/L)(P<0.05),两组间血镉、砷、铬的水平并没有明显差异。血铅的多重线性回归显示,血Pb与年龄及家庭年收入水平呈正相关(P<0.05)。既往不良妊娠结局的多因素logistic回归分析显示,血铅每升高1μg/L,不良妊娠结局发生风险增加3.5%[OR:1.035(95%CI:1.001~1.072)];与肉类日摄入量<100 g的女性相比,肉类日摄入量≥100 g的女性不良妊娠结局发生风险降低[OR:0.112(95%CI:0.011~0.568)]。结论本次调查的广西长老乡女性铅暴露可能与既往不良妊娠结局有关,建议生育期妇女应尽量避免重金属铅暴露。

Objective To explore the association between the internal exposure levels of environmental heavy metals and history of adverse pregnancy outcoms in Hechi,Guangxi.Methods A total of 180 adult females sellected from five villages of Zhanglao of Hechi in Guangxi,were divided into adverse pregnancy group and normal group according to the history of pregnancy outcomes.Inductive coupled plasma mass spectrometry was applied to test heavy metals,such as lead(Pb),cadmium(Cd),arsenic(As)and chromium(Cr)in the whole blood samples.The association between internal exposure to heavy metals and history of adverse pregnancy outcoms was analyzed by multivariate logistic regression.Results The concentration of blood Pb in adverse pregnancy group(41.86μg/L)is significantly higher than that of normal pregnancy group(30.48μg/L)(P<0.05).Multivariate linear regression analysis showed that age and household income were positively correlated with blood lead.Logistic regression analysis showed that the risk of adverse pregnancy outcoms increased by 3.5%for an increase of 1μg/L blood Pb,OR was 1.035(95%CI:1.001-1.072),the daily intake of meat≥100 g could reduce the risk of adverse pregnancy outcomes,OR was 0.112(95%CI:0.112-0.568).Conclusion Lead was related to the adverse pregnancy outcomes,the women of childbearing age in Hechi region should try to avoid the exposure to lead.