孕妇孕期稀土元素的暴露及其对新生儿出生结局的影响  

Association of prenatal exposure to rare earth elements with birth outcomes:a cohort study in China

作　　者：李贝妮 张妤 喻杨依琳 徐梦菲 曹中强 吴微 LI Bei-ni;ZHANG Yu;YU Yang-yi-lin;XU Meng-fei;CAO Zhong-qiang;WU Wei(School of Laboratory Medicine,Hubei University of Chinese Medicine,Wuhan,Hubei 430065,China;不详)

机构地区：[1]湖北中医药大学检验学院,湖北武汉430065 [2]武汉市江岸区妇幼保健院 [3]武汉儿童医院妇女儿童健康研究所

出　　处：《环境与健康杂志》2025年第3期220-226,共7页Journal of Environment and Health

基　　金：武汉市科技局知识创新专项-基础研究(2022020801010567);湖北省教育厅科学技术研究重点项目(D20232003)。

摘　　要：目的基于前瞻性队列研究孕妇人群稀土元素的内暴露水平及其对新生儿出生结局的影响,为研究稀土元素对人类健康的危害提供了参考依据。方法于2013年1月3日至12月31日之间,于武汉儿童医院收集孕妇孕晚期尿液样本,采用电感耦合等离子体质谱法(ICP-MS)测定尿样中13种稀土元素镧(La)、铈(Ce)、镨(Pr)、钕(Nd)、钷(Pm)、钐(Sm)、铕(Eu)、钆(Gd)、铽(Tb)、镝(Dy)、钬(Ho)、铒(Er)、铥(Tm)、镱(Yb)、镥(Lu)的浓度,并通过尿肌酐进行浓度校正。新生儿出生体重(g)和出生身长(cm)由专业的产科护士在胎儿娩出后1 h按标准化程序测量并记录。采用多元线性回归模型分析孕妇孕晚期尿液样本中稀土元素水平对新生儿出生结局间的影响,采用logistic回归分析孕妇孕晚期尿液样本中稀土元素水平与小于胎龄儿(small for gestational age infant,SGA)之间的关联。结果本研究共纳入1633对母婴。孕妇尿液样本中13种稀土元素检出率由高至低分别为镧(98.71%)、镱(98.53%)、镝(98.47%)、铒(97.79%)、铕(97.67%)、钕(97.61%)、铈(96.45%)、钆(95.9%)、镨(95.4%)、钐(94.37%)、铥(94.06%)、钬(91.18%)、镥(20.21%),检出浓度较高的则是Ce、Nd、La,其中位数浓度分别为0.033、0.022、0.020μg/g,经过肌酐校正后,其浓度为0.070、0.044、0.042μg/g,其中La元素与Ce元素之间相关性最大,为0.87。孕妇尿中铈(Ce)浓度每增加1倍,新生儿出生体重增加24.81 g(95%CI:2.50~30.87),Er浓度每增加1倍,新生儿出生体重减少22.70 g(95%CI:-45.40~-0.001);孕妇尿液中铈(Ce)和铥(Tm)的浓度每增加1倍,新生儿出生身长分别增加0.09 cm(95%CI:0.005~0.17)和0.08cm(95%CI:-0.0003~0.17)。孕妇尿液中镨(Pr)浓度每增加1倍,新生儿发生SGA的风险增加46%(95%CI:0.03~0.74)。结论孕妇人群存在普遍的稀土元素暴露,并且孕期稀土暴露水平升高对新生儿出生结局可产生不良影响。Objective This study was aim to investigate prenatal urinary rare earth elements were associated with neonatal birth outcomes based on a prospective cohort in Wuhan.Methods In this study,urine samples were collected from pregnant women in the third trimester of pregnancy in Wuhan Children's Hospital from January3,2013 to December 31,2013,and 13 rare earth elements:lanthanum(La),cerium(Ce),praseodymium(Pr),neodymium(Nd),promethium(Pm),samarium(Sm),europium(Eu),gadolinium(Gd),terbium(Tb),dysprosium(Dy),holmium(Ho),erbium(Er),thulium(Tm),ytterbium(Yb)and lutetium(Lu)were determined by inductively coupled plasma mass spectrometry(ICP-MS)and corrected by urine creatinine.Newborn birth weight(g)and birth length(cm)are measured and recorded after delivery by a professional obstetric nurse according to a standardized procedure.Multiple linear regression model was used to analyze the effect of rare earth element levels in pregnant women on birth outcomes of,and logistic regression was used to analyze the association between rare earth element levels and small-for-gestational-age infants(SGA).Results A total of 1633 maternal and infant pairs were included in this study.The detection rates of 13 rare earth elements in the urine samples of pregnant women were lanthanum(98.71%),ytterbium(98.53%),dysprosium(98.47%),erbium(97.79%),europium(97.67%),neodymium(97.61%),cerium(96.45%),gadolinium(95.9%),praseodymium(95.4%),samarium(94.37%),thulium(94.06%),holmium(91.18%)and lutetium(20.21%).The higher concentrations were found in Ce,Nd,and La,with median concentrations of 0.033μg/g,0.022μg/g,and 0.020μg/g,respectively,corrected for creatinine,and 0.070μg/g,0.044μg/g,and 0.042μg/g,respectively,with the highest correlation between elemental La and elemental Ce at0.87.The birth weight of neonates increased by 24.81 g(95%CI:2.50-30.87)for every 1-fold increase of cerium(Ce)concentration in pregnant women,and 22.70 g(95%CI:-45.40--0.001)for every 1-fold increase in Er concentration.For each doubling increase of cerium(Ce)and thulium

关 键 词：稀土元素 孕期暴露 队列研究 出生结局 

分 类 号：R181.3[医药卫生—流行病学]