摘要
目的 探讨妊娠期饮用水氯化消毒副产物（CDBPs）暴露水平与新生儿小于胎龄儿（SGA）发生风险之间的关系.方法 2010年4月至2012年7月,将武汉市居住在同一供水区域内3 903名产妇纳入研究并收集其分娩信息.以水厂为中心向外设3个采样点,每次取样1次,连续28个月定时定点取样,共检测84份水样中四种三卤甲烷化合物（THMs）,包括三氯甲烷、二氯一溴甲烷（BDCM）、一氯二溴甲烷（DBCM）和三溴甲烷,以及两种卤乙酸类化合物（HAAs）,包括三氯乙酸、二氯乙酸.按照四分位区间将孕妇各孕期CDBPs分为Q1-Q4暴露组,以Q1暴露组为参照,采用logistic回归分析妊娠各期CDBPs外暴露水平与SGA之间的关联.结果 3 903名新生儿出生体重为（3 310.19±389.91）g,其中SGA有169例（4.33%）.孕妇孕全程暴露三氯甲烷、BDCM、溴代THMs、总THMs、三氯乙酸和二氯乙酸的中位数浓度分别为18.07、4.93、8.51、26.74、10.65和13.77 μg/L.logistic回归结果显示,与Q1暴露组相比,Q4暴露组孕全程三氯甲烷、总THMs暴露水平升高与新生儿SGA的OR （95%CI）值分别为1.87（1.01-3.49）、2.30（1.22-4.35）,趋势P值分别为0.044、0.015.与Q1暴露组相比,Q4暴露组孕全程三氯乙酸暴露与SGA的OR（95%CI）值为2.16（1.19-3.91）,趋势P值为0.015.结论 妊娠期暴露高水平CDBPs可能与新生儿SGA发生风险相关.
Objective To explore the associations between exposure to chlorination disinfection by-products （CDBPs） during gestation and newborns＇ small for gestational age （SGA）. Methods During April 2010 to July 2012, a total of 3 903 pregnant women who lived in a district with the same water treatment plant in Wuhan, China were recruited to this perspective study. Information about demographic characteristics of pregnant women and their newborns was collected. The tap water samples were monthly collected for 28 months in 3 different sites, with 84 samples, and 4 kinds of trihalomethanes （THMs） （chloroform （TCM）, bromodichloromethane （BDCM）, dibromochloromethane （DBCM）, and bromoform （TBM）） and 2 kinds of chlorohaloacetic acids （HAAs）（trichloroacetic acid （TCAA）, dichloroacetic acid （DCAA）） were determined. The pregnant women were divided into 4 groups（Q1 to Q4） by quartile method according to their exposure level of CDBPs. Binary Logistic regression models were used to assess the associations between exposure to CDBPs during gestation and newborns＇small for gestational age. Results The average weight of all the newborns was （3 310.19 ± 389.91） g, of which 169 （4.33%） were SGA. The median concentrations of TCM, BDCM, bromo-THMs, total THMs, TCAA, and DCAA during the whole pregnancy were 18.07, 4.93, 8.51, 26.74, 10.65, and 13.77 μg/L, respectively. Binary Logistic regression analysis showed dose-response relationships between elevated TCM and total THMs during the whole gestation and compared with Q1 group, while there was a increased risk of SGA in Q4 group, and OR（95%CI） was 1.87 （1.01-3.49）, 2.30（1.22-4.35）, respectively （P for trend equaled to 0.044, 0.015）. Compare with Q1 group, there also be positive associations between exposure to TCAA （Q4 group） during first-trimester and the whole gestation and SGA, while OR （95%CI ） was 2.16（1.19-3.91） （ P for trend equaled to 0.015）. Conclusion Exposure to CDBPs during gestation m
作者
陈颖君
汪一心
罗彦
程英惠
曹文成
鲁文清
Chen Yingjun;Wang Yixin;Luo Yan;Cheng Yinghui;Cao Wencheng;Lu Wenqing(Department of Occupational and Environmental Health and Key Laboratory of Environment and Health,Ministry of Education ＆ Ministry of Environmental Protection,and State Key Laboratory of Environmental Health（incubating）,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2018年第9期885-891,共7页
Chinese Journal of Preventive Medicine
基金
国家自然科学基金面上项目（81673123）
淡水生态与生物技术国家重点实验室开放基金（2012FB08）
