辅助生殖与自然妊娠孕妇全氟及多氟烷基化合物暴露水平及其社会人口学影响因素的比较分析  

Concentrations and sociodemographic determinants of per-and polyfluoroalkyl substances in women pregnant using assisted reproduction technology in comparison with women pregnant naturally

作　　者：冒丹丹 赵九如 李红[2] 汪子夏 程晓蒙 张妍 刘志伟[2] 高宇 田英 MAO Dandan;ZHAO Jiuru;LI Hong;WANG Zixia;CHENG Xiaomeng;ZHANG Yan;LIU Zhiwei;GAO Yu;TIAN Ying(Department of Environmental Health,School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;MOE-Shanghai Key Laboratory of Children's Environmental Health,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院公共卫生学院环境与健康系,上海200025 [2]上海交通大学医学院附属国际和平妇幼保健院,上海200030 [3]上海交通大学医学院附属新华医院环境与儿童健康教育部与上海市重点实验室,上海200092

出　　处：《环境与职业医学》2024年第6期632-639,共8页Journal of Environmental and Occupational Medicine

基　　金：上海市科委自然科学基金项目(21410711100);国家自然科学基金项目(41991314);上海市卫生健康委2020年协同创新集群项目(2020CXJQ01);上海市加强公共卫生体系建设三年行动计划(2023—2025年)项目(GWVI-4、GWVI-11.1-41)。

摘　　要：[背景]全氟及多氟烷基化合物(PFAS)作为一种持久性有机污染物在人体内普遍检出,其毒性也引起了广泛的关注,但对于辅助生殖与自然妊娠孕妇的PFAS暴露水平与影响因素的比较鲜有报道。[目的]分析并比较上海市辅助生殖和自然妊娠孕妇血清中PFAS的浓度及影响PFAS水平的社会人口学因素。[方法]以国家出生队列(CNBC)在上海地区2017—2019年同期招募的333例接受辅助生殖技术治疗后怀孕的孕妇和689例自然怀孕的孕妇为研究对象,检测了所有孕妇孕早期的血清中32种PFAS的浓度,将两组人群共同暴露水平最高的四种PFAS纳入后续分析,采用多因素线性回归分别分析两组人群人口学特征对血清PFAS浓度的影响,计算β值及其95%可信区间的指数转换值以代表自变量每变化一个单位后PFAS浓度几何均数(GM)的比值。[结果]全氟辛酸(PFOA)、全氟辛基磺酸(PFOS)、6∶2氯代聚氟烷基醚磺酸(6∶2 Cl-PFESA)、全氟己烷磺酸(PFHxS)是辅助生殖孕妇和自然妊娠孕妇血清中最主要的4种PFAS,且辅助生殖孕妇的PFOA、PFOS、6∶2 Cl-PFESA水平高于自然妊娠孕妇(P<0.05)。多因素线性回归的结果发现,怀孕年龄和家庭收入是影响两组人群血清PFAS暴露水平的共性因素。怀孕年龄≥35岁的辅助生殖和自然妊娠孕妇相比怀孕年龄<30岁的各组孕妇的血清PFOS水平分别增加至1.26(95%CI:1.04~1.54)倍和1.24(95%CI:1.08~1.42)倍。相比两组人群家庭年收入<200000元的孕妇,家庭年收入>300000元的辅助生殖孕妇和自然妊娠孕妇血清PFOA[GM比值(95%CI)分别为0.82(0.72~0.95)和0.89(0.81~0.97)]和PFHxS[GM比值(95%CI)分别为0.66(0.51~0.86)和0.77(0.66~0.90)]浓度较低。此外,研究生及以上教育水平比本科以下教育水平的自然妊娠孕妇血清中6∶2 Cl-PFESA浓度低(GM比值:0.81),经产比初产的自然妊娠孕妇血清中PFOS、6∶2 Cl-PFESA和PFHxS浓度增加(GM比值分别为1.14、1.25和1.27)。[�[Background]Per-and polyfuoroalkyl substances(PFAS)are categorized as persistent organic pollutants and commonly detected in humans,and their toxicity has attracted widespread attention.However,few studies have reported comparison of PFAS levels and potential factors between women pregnant using assisted reproduction technology(ART)and women pregnant naturally.[Objective]To analyze and compare serum concentrations and sociodemographic determinants of PFAS in pregnant women conceiving through ART and conceiving naturally from Shanghai.[Methods]Based on the China National Birth Cohort(CNBC)in Shanghai from 2017 to 2019,333 pregnant women conceiving through ART and 689 pregnant women conceiving naturally were recruited during the same period as study subjects.The concentrations of 32 PFAS were measured in early-pregnancy serum of all pregnant women,and four PFAS with the highest co-exposure levels in both groups were included in the subsequent analysis.Multiple linear regression models were performed to evaluate the associations of sociodemographic factors with serum PFAS concentrations in the two groups respectively.Beta coefficients and 95%confidence intervals(CI)were exponentiated to calculate the ratio of the geometric mean(GM)of PFAS concentrations after each unit change in the independent variable.[Results]Perfluorooctanoic acid(PFOA),perfluorooctanesulfonic acid(PFOS),6∶2 chlorinated polyfluoroethersulfonic acid(6∶2 Cl-PFESA),and perfluorohexanesulfonic acid(PFHxS)were four major PFAS in serum of pregnant women conceiving through ART and conceiving naturally,and the concentrations of PFOA,PFOS,and 6∶2 Cl-PFESA were higher in pregnant women conceiving through ART than in pregnant women conceiving naturally(P<0.05).The results of multiple linear regression analysis showed that age at pregnancy and household income were associated with serum PFAS levels in both groups.The serum concentrations of PFOS were higher in pregnant women aged≥35 years old who conceiving through ART(GM ratio=1.26,95%CI:1.04,1.54)

关 键 词：全氟及多氟烷基物质 辅助生殖 自然妊娠 暴露水平 社会人口学影响因素 

分 类 号：R12[医药卫生—环境卫生学]