丁秀丽, 张亚萍, 牛婷婷, 吴琪, 阮晔, 张莉, 牛静萍, 邱慧英, 杨晓棠. 脐带血重金属水平与胎儿生长发育情况的典型相关分析[J]. 环境与职业医学, 2020, 37(4): 368-373. DOI: 10.13213/j.cnki.jeom.2020.19641
引用本文: 丁秀丽, 张亚萍, 牛婷婷, 吴琪, 阮晔, 张莉, 牛静萍, 邱慧英, 杨晓棠. 脐带血重金属水平与胎儿生长发育情况的典型相关分析[J]. 环境与职业医学, 2020, 37(4): 368-373. DOI: 10.13213/j.cnki.jeom.2020.19641
DING Xiu-li, ZHANG Ya-ping, NIU Ting-ting, WU Qi, RUAN Ye, ZHANG Li, NIU Jing-ping, QIU Hui-ying, YANG Xiao-tang. Canonical correlation analysis between heavy metal levels in umbilical cord blood and fetal growth and development[J]. Journal of Environmental and Occupational Medicine, 2020, 37(4): 368-373. DOI: 10.13213/j.cnki.jeom.2020.19641
Citation: DING Xiu-li, ZHANG Ya-ping, NIU Ting-ting, WU Qi, RUAN Ye, ZHANG Li, NIU Jing-ping, QIU Hui-ying, YANG Xiao-tang. Canonical correlation analysis between heavy metal levels in umbilical cord blood and fetal growth and development[J]. Journal of Environmental and Occupational Medicine, 2020, 37(4): 368-373. DOI: 10.13213/j.cnki.jeom.2020.19641

脐带血重金属水平与胎儿生长发育情况的典型相关分析

Canonical correlation analysis between heavy metal levels in umbilical cord blood and fetal growth and development

  • 摘要: 背景

    孕期重金属环境暴露可以影响不同孕期胎儿生长发育情况,重金属暴露对哪一孕期影响最大以及综合评判孕期胎儿生长发育情况与脐带血重金属水平之间的相关关系的研究较为少见。

    目的

    了解重金属暴露状态下,不同孕期胎儿生长发育情况及与脐带血重金属水平之间的相关关系。

    方法

    2013年1月至2016年12月期间,选择甘肃省某重金属污染地区(污染区)及其毗邻的位于污染地区上风侧的另一地区(对照区)作为研究地区,经知情同意后,纳入自愿配合且年龄在22~35周岁、在研究地点连续居住两年以上的单胎妊娠孕产妇。通过问卷调查收集孕妇的基本情况,利用B型超声检查不同时期胎儿双顶径、股骨长度、胎心率等,采用电感耦合等离子质谱仪测定所有孕妇分娩时新生儿脐带血镍、铜、砷水平,采用典型相关分析胎儿双顶径、股骨长度、胎心率与脐带血镍、铜、砷水平两组指标间的相关性。

    结果

    孕中、晚期和分娩时分别纳入研究对象42、58、71名(污染区)和58、91、169名(对照区)。两地区孕妇的基本情况除了孕晚期、分娩时的被动吸烟情况污染区(84.5%、85.9%)高于对照区(44.0%、47.3%)(均P < 0.001)和孕中期、分娩时的孕妇妊娠期合并症污染区(40.5%、38.0%)高于对照区(19.0%、17.8%)(P=0.018,P=0.001)及分娩时孕妇居住地距马路≤ 300m者和孕妇服用药物的比例污染区(60.6%、29.6%)高于对照区(45.0%、12.4%)(P=0.027,P=0.001)差异存在统计学意义外,其他方面差异均无统计学意义。孕中期、孕晚期、分娩时入选的污染区新生儿脐带血砷水平(0.77、0.75、0.73μg·L-1)高于对照区(0.29、0.34、0.35 μg·L-1)(P < 0.001);孕中期、孕晚期、分娩时污染区胎儿股骨长度(35.0、60.0、70.0 mm)小于对照区(41.5、63.0、72.0 mm)(P < 0.01)。孕中期胎儿生长发育与新生儿脐带血重金属水平存在典型相关关系,其典型相关关系式为:U1=0.617X1+0.349X2-0.430X3X1-3分别为双顶径、股骨长度、胎心率);W1=-0.545Y1-0.109Y2-0.897Y3Y1-3分别为镍、铜、砷水平)。即胎儿双顶径、股骨长度与新生儿脐带血镍、铜、砷水平为负相关,胎儿胎心率与新生儿脐带血镍、铜、砷水平为正相关;胎儿双顶径、股骨长度与新生儿脐带血砷水平的相关性最密切。

    结论

    脐带血的重金属水平作为内暴露剂量与孕中期胎儿双顶径、股骨长度存在负相关,孕期重金属暴露对孕中期胎儿的不良影响较大。

     

    Abstract: Background

    Environmental exposure to heavy metals during pregnancy can affect the growth and development of fetuses at different pregnancy stages. However, few studies have been conducted to evaluate which pregnancy stage is most affected and what are the correlations between fetal growth and development during pregnancy and the levels of heavy metals in umbilical cord blood.

    Objective

    This study is conducted to investigate the correlation between fetal growth and development during pregnancy and heavy metal levels in umbilical cord blood under heavy metal exposure.

    Methods

    A heavy metal contaminated area (pollution area) in Gansu Province and another adjacent area (control area) on the windward side of the polluted area were selected as study areas from January 2013 to December 2016. With informed consent, pregnant women with a single fetus, aged 22-35 years, and who volunteered to cooperate the study and lived in the study areas for more than two years were included. Through a questionnaire survey the basic information of the pregnant women were collected. Fetal double top diameter, femur length, and fetal heart rate at different stages were measured by ultrasonic examination. The levels of nickle (Ni), copper (Cu), and arsenic (As) in newborns' umbilical cord blood were measured during delivery with inductively coupled plasma mass spectrometer. The correlations between fetal growth and development indicators (double top diameter, femoral length, and fetal heart rate) and heavy metal levels in umbilical cord blood (Ni, Cu, and As) were analyzed by canonical correlation.

    Results

    During the second trimester, the third trimester, and delivery, there were respectively 42, 58, and 71 pregnant women from the pollution area and 58, 91, and 169 pregnant women from the control area recruited in the study. Except that the pregnant women's passive smoking rates during the third trimester and delivery in the pollution area (84.5% and 85.9%, respectively) were higher than those in the control area (44.0% and 47.3%, respectively) (Ps < 0.001), the complication rates during the second trimester and delivery in the pollution area (40.5% and 38.0%, respectively) were higher than those in the control area (19.0% and 17.8%, respectively) (P=0.018, P=0.001), and the rates of women's residential address ≤ 300 m away from streets and women taking medicine during pregnancy in the pollution area (60.6% and 29.6%, respectively) were higher than those in the control area (45.0% and 12.4%, respectively) (P=0.027, P=0.001), there were no significant differences in other aspects of general information between the women in the two study areas. The levels of umbilical cord blood As of subjects during the second trimester, the third trimester, and delivery in the pollution area (0.77, 0.75, and 0.73 μg·L-1, respectively) were higher than those in the control area (0.29, 0.34, and 0.35 μg·L-1, respectively) (P < 0.001). The femoral lengths of fetuses during the second trimester, the third trimester, and delivery in the pollution area (35.0, 60.0, and 70.0 mm, respectively) were less than those in the control area (41.5, 63.0, and 72.0 mm, respectively) (P < 0.01). Fetal growth and development in the second trimester was canonically correlated with heavy metal levels in umbilical cord blood:U1=0.617X1+0.349X2-0.430X3 (X1-3 were double top diameter, femoral length, and fetal heart rate, respectively); W1=-0.545Y1-0.109Y2-0.897Y3 (Y1-3 were Ni, Cu, and As levels, respectively). In other words, double top diameter and femoral length were negatively correlated with Ni, Cu, and As levels in umbilical cord blood, fetal heart rate was positively correlated with Ni, Cu, and As levels in umbilical cord blood, and fetal double top diameter and femoral length were most correlated with As level in umbilical cord blood.

    Conclusion

    Heavy metal levels in umbilical cord blood as internal exposure doses are negatively correlated with double top diameter and femoral length of the second-trimester fetuses, indicating that metal exposure during pregnancy have a strong adverse health effect on the second-trimester fetuses.

     

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