产前滴滴涕或多氯联苯暴露与出生缺陷风险相关性的Meta分析  

The association between prenatal exposure to dichlorodiphenyltrichloroethane(DDT) or polychlorinated biphenyls(PCBs) and the risk of congenital anomalies:a meta-analysis

作　　者：林瑜 何洁[2] 赵本华[1] 赖圳宾[2] 赵泽宇 于晓姗 陈江慧 林修羽 苏艳华[1] LIN Yu;HE Jie;ZHAO Benhua;LAI Zhenbin;ZHAO Zeyu;YU Xiaoshan;CHEN Jianghui;LIN Xiuyu;SU Yanhua(Department of Preventive Medicine, School of Public Health, Xiamen University;National Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Xiamen, 361002, P.R.China;2. Department of Gastroenterology, The 2nd Hospital of Xiamen City, Xiamen, 361021, P.R.China)

机构地区：[1]厦门大学公共卫生学院预防医学系/分子疫苗学和分子诊断学国家重点实验室 [2]厦门市第二医院消化内科

出　　处：《中国循证医学杂志》2018年第4期365-372,共8页Chinese Journal of Evidence-based Medicine

基　　金：厦门市科技计划项目(编号:3502Z20163006);厦门市集美区科技计划项目(编号:20142C01)

摘　　要：目的系统评价孕妇产前暴露于滴滴涕（DDT）或多氯联苯（PCBs）与新生儿出生缺陷风险之间的关系。方法计算机检索PubMed、EMbase、WanFangData、VIP和CNKI数据库，搜集有关产前DDT或PCBs暴露与出生缺陷关系的病例．对照研究，检索时限均从建库至2017年2月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用Stata13．0软件进行Meta分析。结果共纳入14个研究，包括2238例出生缺陷新生儿和2355例对照新生儿。Meta分析结果显示：产前暴露于高水平的DDT会导致新生儿隐睾发生率增加[OR=I．12，95％CI（1．09，1．15），P〈0．001]。而DDT暴露与尿道下裂和神经管畸形发生没有相关性。产前暴露于高水平的PCBs与隐睾、尿道下裂、神经管畸形发生也没有相关性。结论孕妇产前暴露于高水平的DDT可能是隐睾发生的危险因素。受纳入研究数量和质量的限制，上述结论尚待更多高质量研究予以验证。Objective To systematically review the association between prenatal exposure to dichlorodiphenyltrichloroethane （DDT） or polychlorinated biphenyls （PCBs） and the risk of congenital anomalies. Methods PubMed, EMbase, WanFang Data, VIP and CNKI databases were electronically searched to collect casecontrol studies on the relationship between prenatal exposure to DDT or PCBs and congenital anomalies from inception to February 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 13.0 software. Results A total of 14 studies involving 2 238 infants with defect and 2 335 infants without defect were included. The results of meta-analysis showed that： the prenatal exposure to high level of DDT increased the incidence of cryptorchidism （OR=1.12, 95% CI 1.09 to 1.15, P〈0.001）. However, DDT exposure had no correlation to hypospadias and neural tube defects. The associations between prenatal exposure to PCBs and cryptorchidism, hypospadias, neural tube defects were not discovered. Conclusion Prenatal exposure to high levels of DDT may be a risk factor for cryptorchidism. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.

关 键 词：滴滴涕 多氯联苯 产前暴露 出生缺陷 系统评价 META分析 病例-对照研究 

分 类 号：R714[医药卫生—妇产科学]