低剂量抗生素暴露对胎儿生长发育的影响  

Effects of Low-dose Antibiotic Exposure on Fetal Growth and Development

作　　者：王亚新 马良坤[1] 李小刚 张素菡 刘娜娜 刘俊涛[1] 林航 孙崟[1] WANG Yaxin;MA Liangkun;LI Xiaogang;ZHANG Suhan;LIU Nana;LIU Juntao;LIN Hang;SUN Yin(Department of Obstetrics and Gynecology,National Clinical Research Center for Obstetric&Gynecologic Diseases,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Medical Research Center,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;State Key Laboratory of Complex Severe and Rare Diseases,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院妇产科,国家妇产疾病临床医学研究中心,北京100730 [2]中国医学科学院,北京协和医学院,北京协和医院医学科学研究中心,北京100730 [3]中国医学科学院,北京协和医学院,北京协和医院疑难重症及罕见病国家重点实验室,北京100730

出　　处：《中国医学科学院学报》2022年第3期411-414,共4页Acta Academiae Medicinae Sinicae

基　　金：中国医学科学院中央级公益性科研院所基本科研业务费(2019XK320007)和中国医学科学院医学与健康科技创新工程项目(2020-I2M-2-009、2021-I2M-1-023)。

摘　　要：目的分析孕晚期母体血液中非治疗性抗生素的暴露情况,探讨低剂量抗生素对胎儿宫内生长发育的影响。方法收集北京协和医院规律产检及分娩的无严重妊娠合并症及并发症的孕妇,排除孕前2个月和/或孕期接受过治疗性抗生素使用的病例,纳入104名孕晚期(28~32周)孕妇,采用液相色谱-串联质谱法对母体血液的抗生素水平进行检测,并将孕妇分为抗生素暴露组(抗生素阳性)和非暴露组(抗生素阴性),测量两组新生儿身长和体重、胎盘重量及胎盘体积,采用t检验或χ^(2)检验对数据进行统计学分析。结果104名孕妇中抗生素暴露组7名(6.73%),非暴露组97名(93.27%)。抗生素暴露组新生儿平均身长(49.57±1.40)cm,非暴露组新生儿平均身长(48.85±1.77)cm,两组比较差异无统计学意义(t=1.060,P=0.363);抗生素暴露组新生儿平均体重(3558.57±382.95)g,非暴露组新生儿平均体重(3275.36±356.41)g,两组比较差异有统计学意义(t=2.021,P=0.046);抗生素暴露组平均胎盘重量(676.43±124.59)g,非暴露组平均胎盘重量(631.96±129.25)g,两组比较差异无统计学意义(t=0.881,P=0.380);抗生素暴露组平均胎盘体积(724.67±174.91)cm^(3),非暴露组平均胎盘体积(676.82±220.86)cm^(3),两组比较差异无统计学意义(t=0.560,P=0.388)。与非暴露组比较,抗生素暴露组新生儿身长、体重、胎盘重量、胎盘体积增加的百分比分别为1.47%、8.65%、7.04%、7.07%。结论环境中存在抗生素暴露,母体血液中非治疗性抗生素暴露能够增加胎儿及胎盘的生长发育水平,尤其以胎儿体重的增加最为显著。Objective To analyze maternal blood exposure to non-therapeutic antibiotics in late pregnancy and explore the effects of low-dose antibiotics on fetal growth and development.Methods A total of 104 pregnant women in late pregnancy(28-32 weeks)without serious pregnancy complications were enrolled,who had regular antenatal examination and delivery in Peking Union Medical College Hospital and did not use therapeutic antibiotics 2 months before pregnancy and in the whole pregnant process.The levels of antibiotics in the maternal blood were detected by liquid chromatography-tandem mass spectrometry,and the pregnant women were assigned into an antibiotic exposure group(antibiotic positive)and a non-exposure group(antibiotic negative).The length,weight,placental weight,and placental volume of the newborns in the two groups were measured,and the data were statistically analyzed by t test orχ^(2) test.Results The maternal blood antibiotic test showed 7 positive cases(6.73%,antibiotic exposure group)and 97 negative cases(93.27%,non-exposure group).The average length of newborns in the antibiotic exposure group and the non-exposure group was(49.57±1.40)cm and(48.85±1.77)cm,respectively,with no significant difference(t=1.060,P=0.363).The average weight of newborns in the antibiotic exposure group and the non-exposure group was(3558.57±382.95)g and(3275.36±356.41)g,respectively,with significant difference(t=2.021,P=0.046).The mean placental weight in the antibiotic exposure group and the non-exposure group was(676.43±124.59)g and(631.96±129.25)g,respectively,with no significant difference(t=0.881,P=0.380).The mean placental volume in the antibiotic exposure group and the non-exposure group was(724.67±174.91)cm^(3) and(676.82±220.86)cm^(3),respectively,with no significant difference(t=0.560,P=0.388).Compared with those in the non-exposure group,the neonatal length,neonatal weight,placental weight,and placental volume in the antibiotic exposure group increased by 1.47%,8.65%,7.04%,and 7.07%,respectively.Conclusion There

关 键 词：孕期 食源性 抗生素 胎儿 生长发育 

分 类 号：R714.51[医药卫生—妇产科学]