孕妇邻苯二甲酸酯内暴露水平及影响因素研究  

Levels of phthalate internal exposure levels in pregnant women and influencing factors

作　　者：杨月[1] 施明明[1] 陈碧钦 林剑锋[3] 杨松静 朱宝平[3] 庄宝玲 贾玉珠[3] 黄桢翔 陈静[1] 刘惠芬[1] 陈江慧 苏艳华[1] 柯遐义[1] 赵本华[1] 

机构地区：[1]厦门大学公共卫生学院,361102 [2]厦门市思明区妇幼保健院医务科 [3]厦门市疾病预防控制中心检验科 [4]厦门市思明区妇幼保健院 [5]厦门市思明区妇幼保健院医技科

出　　处：《中华预防医学杂志》2015年第11期998-1004,共7页Chinese Journal of Preventive Medicine

基　　金：福建省自然科学基金（2012J01412）;厦门市科技计划项目（3502220144070）

摘　　要：目的分析孕妇（孕周≤16周）邻苯二甲酸酯内暴露水平及其影响因素。方法选取2013年4—6月在厦门市思明区妇幼保健院建立孕产妇保健手册的1020名孕妇（孕周≤16周）纳入研究，采用调查问卷收集孕妇人口学信息、孕期生活方式以及产检信息，并收集其尿样，最终完成问卷调查并收集尿样的孕妇共998名。以此为抽样人群，采用系统抽样的方法，从中随机抽取100名孕妇作为研究对象。应用固相萃取一高效液相色谱串联质谱技术检测研究对象尿液中5种邻苯二甲酸单酯的含量，包括邻苯二甲酸单甲酯（MMP）、邻苯二甲酸单乙酯（MEP）、邻苯二甲酸单丁酯（MBP）、邻苯二甲酸单苄基酯（MBzP）和邻苯二甲酸-单一乙基己基酯（MEHP），同时结合调查问卷信息，采用多因素logistic回归模型分析孕妇各邻苯二甲酸单酯水平的影响因素。结果100份孕妇（孕周≤16周）尿样中，5种邻苯二甲酸单酯MMP、MEP、MBP、MBzP和MEHP的检m率分别为94％、93％、87％、83％、99％，含量的中位数分别为20．56、17．62、10．15、2．03、5．12ng／ml，经尿比重校正后分别为20．81、20．36、12．88、2．58、5．00ng／ml。多因素logistic回归分析结果显示：随着文化程度的提高，孕妇尿液中MMP、MEP、MBP、MBzP和MEHP含量均呈下降的趋势，OR（95％CI）值分别为0．495（0．253～0．966）、0．380（0．191～0．755）、0．379（0．186～0．774）、0．401（0．196～0．819）、0．373（0．183～0．762）；孕期烫染头发会使尿液中MBP和MBzP的含量增加，0R（95％CI）值分别为12．867（1．240-q33．525）、15．982（1．367-186．911）；孕期使用化妆品会使尿液中MEP和MBP的含量增加，OR（95％C／）值分别为2．977（1．012-8．757）、4．440（1．485-13．272）；饮用水类型与尿液中MEP和MEHP含量的增加有关，饮用桶装、瓶装水会增加其含量，ORObjective To investigate the levels and influencing factors of phthalate intenlal exposure in pregnant women（gestation age ≤16 weeks）. Methods During April to June in 2013, 1 020 pregnant women（gestation age ≤16 weeks） who had established the maternal care manual were recruited in maternal and child health hospital of Siming District, Xiamen city. Participators were asked to complete a questionnaire to obtain information on socio-demographic characteristics, lifestyle behaviors, and antenatal examination and to provide a urine sample. Finally, 998 pregnant women who provided a urine sample and completed the questionnaire were enrolled. Adopting systematic sampling method, 100 ones were selected randomly among 998 pregnant women. High performance liquid chromatography-eleetrospray ionization-tandern mass was used to determine the concentration of five phthalate monoesters in each urine, including mono-n-methyl phthalate （MMP）, mono-ethyl phthalate （MEP）, mono-butyl phthalate （MBP）, mono-benzyl phthalate （MBzP）, mono-ethylhexyl phthalate （MEHP）. Based on the measurements and questionnaire data, multivariate logistic regression was used to analyze the association between the phthalate monoester levels and potential influential factors. Results The detection rates of MMP, MEP, MBP, MBzP and MEHP in 100 pregnant urine samples were 94%, 93%, 87%, 83%, 99%, respectively. And the urinary median uncorrected concentrations of MMP, MEP, MBP, MBzP and MEHP in 100 urine samples were 20.56, 17.62, 10.15, 2.03, and 5.12 ng/ml, respectively. Specific gravity-corrected concentration were 20.81, 20.36, 12.88, 2.58, 5.00 ng/ml, respectively. The results of muhivariate logistic regression analysis indicated that： education degree was negatively associated with urinary concentration of MMP, MEP, MBP, MBzP and MEHP, OR （95%C/） were 0.495 （0.253-0.966）, 0.380 （0.191-0.755）, 0.379 （0.186-0.774）, 0.401 （0.196- 0.819）, 0.373（0.183-0.762）, respectively. Participants who had hair per

关 键 词：孕妇 甲酸酯类 母亲暴露 影响因素 

分 类 号：R714.2[医药卫生—妇产科学]