妇女孕前至孕期血镉和脐血镉水平及其影响因素  

Cadmium levels in women from preconception to pregnancy and cord blood and their influencing factors

作　　者：武常倩 蒋泓 张玉 马晓英 喇雪娜 毛红芳[2] 尹东晓 蔡徐山[3] 吴守乐[3] 李强[4] 钱序 WU Chang-qian;JIANG Hong;ZHANG Yu;MA Xiao-ying;LA Xue-na;MAO Hong-fang;YIN Dong-xiao;CAI Xu-shan;WU Shou-le;LI Qiang;QIAN Xu(Key Laboratory of Health Technology Assessment of National Health Commission-Department of Maternal,Child and Adolescent Health,School of Public Health,Fudan University,Shanghai 200032,China;Department of Women Health Care,Maternal and Child Health Care Hospital of Jiading District,Shanghai 201812,China;Department of Clinical Laboratory,Maternal and Child Health Care Hospital of Jiading District,Shanghai 201812,China;Putuo Center for Disease Control and Prevention,Shanghai 200333,China)

机构地区：[1]复旦大学公共卫生学院妇幼与儿少卫生教研室-国家卫健委卫生技术评估重点实验室,上海200032 [2]上海市嘉定区妇幼保健院妇女保健科,上海201812 [3]上海市嘉定区妇幼保健院检验科,上海201812 [4]上海市普陀区疾病预防控制中心,上海200333

出　　处：《复旦学报（医学版）》2020年第2期226-231,共6页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金(81973057);上海市第四轮公共卫生三年行动计划(15GWZK0402);上海市公共卫生与预防医学Ⅰ类高峰学科建设计划;上海市自然科学基金(19ZR1405900)。

摘　　要：目的探究妇女孕前、孕中期和孕晚期血镉及脐血镉水平的变化趋势及其影响因素。方法以复旦孕前队列研究(PLOTS)为基础,对来自上海市嘉定区的92名妇女,采用电感耦合等离子体质谱法检测孕前至孕期全血和脐血,共368份血样的镉浓度,并分析孕期血镉和脐血镉水平的影响因素。结果孕前、孕中期和孕晚期血镉及脐血镉的中位数浓度分别为1.32、0.94、1.65和1.16μg/L,所有血样镉浓度均未超过一般人群参考值(5μg/L)。血镉浓度比较:孕中期低于孕前,孕晚期高于孕中期,脐血低于孕晚期(P<0.01)。孕前血镉水平与孕期血镉和脐血镉水平呈正相关(P<0.01)。上海本地户籍、大学及以上文化程度和孕期喝纯果蔬汁至少每周1次的妇女孕期血镉和脐血镉浓度较低(P<0.05),孕期被动吸烟的妇女孕期血镉和脐血镉浓度较高(P<0.05)。结论建议妇女在孕前降低血镉水平,并在孕期避免被动吸烟。孕期喝果蔬汁可能是降低血镉浓度的保护因素。Objective To explore the pattern of cadmium(Cd)levels in preconception,the second trimester and the third trimester of pregnancy among women and newborns at delivery,and the influencing factors.Methods Based on the Preconceptional Offspring Trajectory Study(PLOTS),women from Jiading District,Shanghai were recruited in preconception and were followed up to the second and the third trimester of pregnancy and until childbirth.Their blood samples were collected at the time points of preconception,the second trimester and the third trimester of pregnancy and until childbirth.Plasma mass spectrometry was used to measure concentrations of Cd in a total of 368 blood samples.Factors associated with maternal blood Cd and cord blood Cd levels were explored.Results The median concentration of blood Cd in preconception,the second trimester and the third trimester and cord blood Cd was 1.32,0.94,1.65 and 1.16μg/L,respectively.The concentrations of blood Cd among all samples were below the reference value of the general population(5μg/L).The concentration of blood Cd in the second trimester was significantly lower than that in preconception(P<0.01).The concentration of blood Cd in the third trimester was significantly higher than that in the second trimester and cord blood(P<0.01).The blood Cd level before pregnancy was positively correlated with Cd levels of maternal blood and cord blood(P<0.01).The levels of maternal blood Cd and cord blood Cd were lower among women with Shanghai household registration,bachelor’s degree or above and juice intake during pregnancy at least once per week(P<0.05).The levels of maternal blood Cd and cord blood Cd were significantly higher among women who were exposed to passive smoking during pregnancy(P<0.05).Conclusion It is suggested for women to decrease blood Cd level during preconception and avoid the exposure to passive smoking during pregnancy.Juice intake during pregnancy might be a protective factor of decreasing blood Cd.

关 键 词：镉(CD) 孕前 孕妇 脐血 影响因素 

分 类 号：R715.3[医药卫生—妇产科学]