上海地区辅助生殖女性孕前多种农药的暴露水平及其影响因素  

Preconceptional exposure levels and determinants of multiple pesticides among women undergoing assisted reproductive technology in Shanghai

作　　者：夏转宁 张妍[1] 胡培培 赵九如 刘志伟[3] 田英[1,4] 高宇[1] XIA Zhuanning;ZHANG Yan;HU Peipei;ZHAO Jiuru;LIU Zhiwei;TIAN Ying;GAO Yu(School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;International Peace Maternity and Child Health Hospital Affiliated to 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,上海200025 [2]上海交通大学医学院附属新华医院,上海200092 [3]上海交通大学医学院附属国际和平妇幼保健院,上海200030 [4]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和上海市重点实验室,上海200092

出　　处：《环境与职业医学》2024年第6期640-647,共8页Journal of Environmental and Occupational Medicine

基　　金：上海市科委自然科学基金项目(22ZR1435600);上海市加强公共卫生体系建设三年行动计划项目(2023-2025年)(GWVI-11.1-41)。

摘　　要：[背景]农药暴露可能会影响接受辅助生殖技术(ART)治疗女性的生殖健康,然而,目前我国有关ART女性农药暴露水平的数据缺乏且探讨其影响因素的研究较少。[目的]了解ART女性孕前农药的暴露水平及其影响因素。[方法]本研究采用横断面设计的调查方法,于2017年7月至2018年12月在上海交通大学医学院附属国际和平妇幼保健院生殖门诊招募了508名接受ART治疗的女性作为研究对象。采用气相/液相色谱-串联质谱法检测ART女性尿液中有机磷类农药(OPs)、拟除虫菊酯类农药(PYRs)以及新烟碱类农药(NEOs)的代谢产物浓度,并分别计算三类农药代谢产物的摩尔浓度总和(∑2OPs、∑2PYRs、∑2NEOs)以评估农药暴露水平。使用问卷调查ART女性的人口学特征、饮食频率以及行为习惯信息。采用多因素线性回归分析人口学特征、饮食频率以及行为习惯与ART女性尿液中农药代谢产物浓度的关系。[结果]本研究人群中∑2OPs、∑2PYRs、∑2NEOs经尿肌酐校正后的中位浓度分别为419.77、2.95、20.36 nmol·g^(−1)。多因素线性回归结果显示:每天摄入蔬菜的ART女性尿液中∑2OPs浓度比蔬菜摄入频率≤3 d·周^(−1)的ART女性高42.88%(P<0.05)。每天摄入水果的ART女性尿液中∑2PYRs浓度比水果摄入频率≤3 d·周−1的ART女性高37.24%(P<0.01)。每天摄入水果和每周有4~6 d摄入水果的ART女性尿液中∑2NEOs浓度比水果摄入频率≤3 d·周^(−1)的ART女性分别高24.51%和29.30%(P<0.05)。此外,本研究还发现∑2PYRs浓度与ART女性体重指数(BMI)呈负相关(P<0.05);而∑2NEOs的浓度不仅与ART女性年龄呈正相关(P<0.05),还与宠物饲养情况以及不孕原因具有关联。备孕后仍在饲养宠物的ART女性尿液∑2NEOs浓度比从不饲养宠物的ART女性高30.11%(P<0.05);由于女性原因导致不孕而接受ART治疗的女性尿液中∑2NEOs浓度比由男性原因导致不孕而接受ART治疗的�[Background]Pesticide exposure may impact the reproductive health of women undergoing assisted reproductive technology(ART).However,data on pesticide exposure levels in women undergoing ART in China are scarce,and current research on influencing factors is limited.[Objective]To evaluate the preconceptional pesticide exposure levels and identify potential determinants among women undergoing ART.[Methods]This study was designed as a cross-sectional survey and recruited 508 women undergoing ART from July 2017 to December 2018 at the fertility clinic of the International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.Gas chromatography/liquid chromatography-tandem mass spectrometry was used to determine the metabolite concentrations of organophosphate pesticides(OPs),pyrethroid pesticides(PYRs),and neonicotinoid pesticides(NEOs)in urine.The sum of molar concentrations of the three pesticide classes(∑2OPs,∑2PYRs,and ∑2NEOs)were calculated.A questionnaire was used to collect demographic characteristics,dietary habits,and behavioral information.Multiple linear regression was employed to analyze the associations of demographic characteristics,dietary habits,and behavioral variables with the concentrations of pesticide metabolites in urine among the participants.[Results]The median creatinine-adjusted concentrations of ∑2OPs,∑2PYRs,and ∑2NEOs in this study were 419.77,2.95,and 20.36 nmol·g^(−1),respectively.The multiple linear regression results showed that the urinary concentration of ∑2OPs was 42.88%higher in the participants with daily vegetable intake than in those who consumed vegetables≤3 d per week(P<0.05),and the urinary concentration of ∑2PYRs was 37.24%higher in the participants with daily fruit intake than in those who consumed fruits≤3 d per week(P<0.01).Similarly,the urinary concentrations of ∑2NEOs were 24.51%and 29.30% higher in the participants who consumed fruits daily and 4-6 d per week,respectively,than in those who consu

关 键 词：辅助生殖 农药 暴露水平 饮食因素 不孕原因 

分 类 号：R12[医药卫生—环境卫生学]