摘要
目的探讨孕期母体多环芳烃(PAHs)暴露与新生儿神经行为发育关系。方法采用方便抽样方法,以长治市A医院和太原市B医院的296对产妇及新生儿为研究对象。采用高效液相色谱法测定2家医院空气中PAHs水平;对产妇进行问卷调查,采用高效液相色谱法测定产妇产前24 h尿中PAHs代谢物水平作为内暴露指标,根据其第25、75百分位数分为PAHs低、中和高暴露组;测量新生儿出生体质量、出生头围和出生身长,采用新生儿神经行为测定(NBNA)评价新生儿神经行为发育情况。结果产妇尿中总PAHs代谢物水平的中位数为0.94 mg/mol肌酐。PAHs高暴露组新生儿NBNA总分、行为能力得分和主动肌张力得分分别低于PAHs低、中暴露组(P<0.05);PAHs中暴露组新生儿NBNA总分和主动肌张力得分分别低于PAHs低暴露组(P<0.05)。3组新生儿出生体质量、出生头围、出生身长以及被动肌张力、原始反射和一般反应得分分别比较,差异均无统计学意义(P>0.05)。多重逐步线性回归分析显示,在排除混杂因素的影响后,产妇尿中PAHs代谢物水平与新生儿NBNA总分、行为能力得分、主动肌张力得分、一般反应得分均呈负相关(P<0.05),与新生儿出生体质量、出生头围、出生身长、被动肌张力得分和原始反射得分均无关联(P>0.05)。结论产妇产前尿中总PAHs代谢物水平与新生儿神经行为发育有关,孕期母体PAHs暴露可能对新生儿神经行为发育产生不良影响。
Objective To explore the relationship between maternal polycyclic aromatic hydrocarbons （PAHs） exposure during pregnancy and neonatal neurobehavioral development. Methods A total of 296 pairs of pregnant women and their newborns in hospital A in Changzhi City and hospital B in Taiyuan City were selected as research subjects by convenience sampling method. The air PAHs levels in these two hospitals were measured using high performance liquid chromatography （HPLC）. The pregnant women were investigated by questionnaires. The levels of PAHs metabolites in prenatal 24-hour urine samples were measured as indicators of exposure using HPLC. The pregnant women were divided into PAHs low-, medium- and high-exposure groups based on the 25th and the 75th percentile levels. The neonatal birth weight, head circumference and birth length were measured, and the neonatal neurobehavioral development was measured by neonatal behavioral neurological assessment （NBNA）. Results The median level of total PAHs metabolite in maternal urine was 0. 94 mg/moL ereatinine. The newborn total NBNA scores, behavioral abilities and active muscle tension scores in the PAHs high-exposure group were lower than that of PAHs low- and medium-exposure groups （ P 〈 0. 05 ）. The newborn total NBNA scores and active muscle tension scores in the PAHs medium-exposure group were lower than that of PAHs low- exposure group （ P 〈 0. 05 ）. There was no significant difference in scores of neonatal weight, head circumference, birth length, passive muscular tension, primary reflexes and general reaction among these three groups （ P 〉 0. 05 ）. The multiple stepwise linear regression analysis results showed that the level of PAHs metabolite in maternal urine were negatively correlated with the total NBNA scores, behavioral abilities score, active muscle tension scores and general reaction score （ P 〈 0. 05 ） , and showed no correlation with the neonatal birth weight, head circumference, passive muscular tension score, birth length and primary reflexes scores （ P 〉 0. 05 ）. Conclusion The level of total PAHs metabolites in maternal prenatal urine is associated with neonatal neurobehavioral development. This result indicates that maternal PAHs exposure during pregnancy may have adverse effects on neonatal neurobehavioral development.
出处
《中国职业医学》
CAS
北大核心
2017年第6期689-694,共6页
China Occupational Medicine
基金
国家自然科学基金(81673143
30800899)
山西省自然科学基金(2015011128)
山西医科大学2016年大学生创新创业校级项目(20160303)
关键词
孕期
多环芳烃
新生儿
神经行为
发育
Pregnancy
Polycyclic aromatic hydrocarbons
Newborn
Neurobehavior
Development
