孕期和脐带血清砷水平及其与妊娠期高血压疾病关系  

Association between maternal and umbilical cord blood arsenic level and hypertensive disorder complicating pregnancy

作　　者：冯兰兰 梁春梅 黄锟 严双琴[2] 李志娟 陶翊然 童世庐 陶芳标 FENG Lan-lan;LIANG Chun-mei;HUANG Kun(Department of Maternal,Child and Adolescent Health,School of Public Health,Anhui Provincial Key Laboratory of Population Health and Aristogenics,Anhui Medical University,Hefei,Anhui Province 230032,China)

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系人口健康与优生安徽省重点实验室,安徽合肥230032 [2]马鞍山市妇幼保健院

出　　处：《中国公共卫生》2019年第5期542-545,共4页Chinese Journal of Public Health

基　　金：国家重点研发计划重点专项(2016YFC1000204–2)

摘　　要：目的描述安徽省马鞍山市孕早、中期孕妇外周血和脐带血清砷水平,并探讨其与妊娠期高血压疾病的关系。方法选取2013年5月—2014年9月马鞍山优生优育队列(MABC)纳入的3474名孕妇作为研究对象,在孕妇孕早期首次产检时收集其一般人口学信息,使用电感耦合等离子质谱仪(ICP-MS)测定孕妇孕早、中期和分娩时脐带血清砷含量,采用logistic回归模型分析孕妇孕早、中期及脐带血清砷水平与妊娠期高血压疾病(HDCP)的关联。结果随访的3247名孕妇中HDCP发生率为5.9%。孕妇孕早、中期及脐带血清砷水平[P50(P25~P75)]分别为1.74(1.22~2.51)、1.77(1.28~2.54)、1.87(1.27~2.88)μg/L,脐带血中砷的含量显著高于孕早、中期孕妇体内砷的含量(P<0.001)。logistic回归分析显示,孕早期血清砷高暴露组孕妇发生HDCP的风险是低暴露组的1.63倍(95%CI=1.08~2.48),孕中期和脐带血清砷水平与HDCP发生无统计学关联(P>0.05)。结论脐带血中砷水平高于孕妇孕早、中期;孕早期砷高暴露可增加HDCP的发生风险。Objective To describe serum arsenic levels in peripheral blood during first or second trimester and umbilical cord blood of pregnant women in Ma'anshan city of Anhui province and to explore correlations between the arsenic levels and hypertensive disorder complicating pregnancy (HDCP).Methods A total of 3 474 pregnant women were consecutively recruited in Ma'anshan Birth Cohort study between May 2013 and September 2014. Demographic information were collected at the first prenatal examination in first trimester. Maternal serum arsenic in the early and second trimester, and arsenic level in umbilical cord blood at delivery were detected via inductively coupled plasma mass spectrometry (ICP-MS). Logistic regression models were established to evaluate the association of arsenic levels during pregnancy and in umbilical cord blood with HDCP.Results The incidence of HDCP was 5.9% among all the pregnant woman. The median and interquartile ranges (25 percentage point-75 percentage point) of serum arsenic in the first trimester, second trimester and umbilical cord blood were 1.74 (1.22-2.51), 1.77 (1.28-2.54), and 1.87 (1.27-2.88)μg/L, respectively. The serum arsenic level in umbilical cord blood was higher than that of peripheral blood during first and second trimester of pregnancy, with significant difference (both P < 0.001). Logistic regression analysis indicated that the pregnant women with higher serum arsenic during first trimester had a 1.63 (95% confidence interval: 1.08-2.48) times higher risk of HDCP compared to the women with low serum arsenic;but there was no significantly observed association of serum arsenic in peripheral blood during second trimester and in umbilical cord blood with HDCP (P > 0.05).Conclusion Serum arsenic concentration in umbilical cord blood is higher than that in maternal peripheral blood during first and second trimesters. High exposure to serum arsenic in first trimester could increase the risk of HDCP.

关 键 词：砷 妊娠高血压 队列研究 

分 类 号：R173[医药卫生—妇幼卫生保健]