北京石景山地区孕妇女婴幼儿血铅动态研究

在严格的质量保证措施下，北京石景山地区２７０名孕妇及其婴儿进行了血铅的追瞎调查。结果显示：孕３月血铅水平为４５．０μｇ／Ｌ，分娩前血铅水平为６４．８μｇ／Ｌ，孕期血铅呈升高趋势，其中后３月升高明显，分娩前血铅约为孕３月血铅的１．５倍；脐带血铅水平为５１．９μｇ／Ｌ，其中有１０．４％的胎儿脐血铅高于１００μｇ／Ｌ；     

北京石景山地区孕妇及婴幼儿游离红细胞原卟啉与血铅关系的研究

为探讨低水平铅暴露人群体内游离红细胞原卟啉（ＦＥＰ）与血铅（ＰｂＢ）的关系,在严格的质量保证措施下,对北京石景山地区２７０名孕妇及其婴幼儿进行了游离红细胞原卟啉及血铅的追踪研究。结果显示：孕妇血中ＦＥＰ水平为３１．７～３８．３μｇ／ｄＬ（ｎ＝５７８）,脐带血中ＦＥＰ水平为４８．８±２３．６μｇ／ｄＬ（ｎ＝１３３）,婴幼儿各年龄组间ＦＥＰ水平无显著性差异,为３７．２～３９．５μｇ／ｄＬ（ｎ＝３５７）     

湖北地区孕妇血铅水平及其对子代影响的研究

对湖北地区非职业铅接触的90名孕妇和新生儿血铅及生长发育情况进行了追踪调查.结果显示:孕28周内血铅水平为0.290μmol/L,分娩前为0.326μmol/L,孕期血铅水平呈增高趋势.新生儿脐血血铅含量为0.333μmol/L,其中178%的新生儿脐血血铅含量高于0.483μmol/L.逐步回归分析显示新生儿脐血血铅含量(Y3)与孕28周内血铅(Y1)及分娩前血铅(Y2)均有高度线性关系:Y3=0.12251067+016094591Y1+0.78077865Y2.Y3与Y2之间的直线相关系数r=0.6805,P<0.01.但母体铅暴露水平对胎儿生长发育尚未造成明显影响.     

北京石景山地区孕妇及婴幼儿血清锌的动态研究

北京石景山地区孕妇及婴幼儿血清锌的动态研究北京首钢医院课题组秦效英刘建荣董兵白雪涛郑星泉（中国预防医学科学院环境卫生监测所，北京１０００２１）锌与胎儿发育甚为密切，妊娠期妇女需要大量的锌来维持母体自身的代谢调节和胎儿发育的需要。若此时锌供给不足，会影...     

孕妇和婴幼儿血铅变化及其影响因素分析

目的观察分析孕妇及婴幼儿血铅变化及其影响因素.方法对妊娠3个月左右的孕妇的血铅水平开始进行追踪观察,并随访其子女血铅水平至2岁.对孕妇的分娩情况以及个人、家庭的一般情况及婴幼儿喂养和发育情况进行调查.分析孕妇和其子女血铅负荷的变化趋势和影响因素.结果妊娠3、6月和分娩前血铅平均值分别为50.3μg/L、51.6μg/L和70.4μg/L.脐带血铅平均值为57.4μg/L,较分娩前血铅明显下降(P<0.05).且两者具有显着性相关(r=0.97,P<0.05).婴幼儿血铅值及其大于100μg/L的百分比随年龄增加呈明显的增加趋势.至2岁时可达32%.结论家庭环境对孕妇血铅有一定影响.婴幼儿血铅随年龄快速增加,这与婴幼儿接触铅的机会增多有关,而影响幼儿接触铅的因素包括家庭房屋类型、喂养情况、母亲工种、年龄和文化程度.     

湖北三个不同空气污染地区孕妇血铅、乳铅的动态观察

在严格质量控制条件下,对湖北省的繁华城区（武汉市）、矿区（大冶）及乡村（宜都）３个不同空气污染地区非职业铅接触的１０５名非孕妇女血铅和９６名孕妇血铅和乳铅含量进行了追踪调查。结果乡村非孕妇女的血铅水平低于城区和矿区,但城区乳铅水平及孕末期血铅水平低于矿区及乡村。对这种差别的影响因素进行了讨论。结论认为,乡村妇女铅暴露水平低于城市和工矿区,但不可忽视极低浓度的铅污染对孕妇存在的潜在危害。     

永康市孕妇血铅与其新生儿脐血铅相关性研究

目的:了解孕妇血铅及其新生儿脐血铅水平,了解两者相关性。方法:选取998例孕妇静脉血及其新生儿脐带血,采用阳极溶出伏安法进行血铅含量的测定。结果:孕妇血铅中毒率为2.91%,中位数为0.173μmol/L,新生儿中毒率为1.90%,中位数为0.138μmol/L,孕妇血铅与新生儿脐血铅含量呈对数正相关(P<0.05)。结论:孕妇血铅含量高低与其新生儿的血铅值呈对数正相关,母血铅高于脐血铅。     

416名孕妇血铅水平及相关因素分析

目的了解武汉市孕妇血铅水平及影响因素,以采取干预措施降低孕妇铅负荷,改善胎儿铅暴露状况。方法将2005年6月12日~2006年6月25日期间到本院进行产前检查的正常孕妇(无并发症或合并症)作为调查对象,进行末梢血血铅测定,并现场询问完成“孕妇血铅水平及影响因素调查表”的填写。所有资料输入微机,用美国SPSS公司生产SPSS-PC软件包进行统计分析。结果416名孕妇血铅值在18~132μg/L之间,均值为41.3μg/L,高铅血症(血铅≥100μg/L)孕妇5例,占1.20%。单因素分析结果显示血铅水平因孕妇文化程度、职业、孕周、居室附近铅作业工厂、家庭铅作业人员、进食前洗手习惯等因素不同而差异有显著性意义。多元逐步回归分析结果,孕周、居室附近铅作业工厂、进食前洗手习惯、孕妇文化程度4个因素进入多元逐步回归方程。结论调查的孕妇高铅血症和铅中毒现患率处于较低水平;进食前洗手习惯、文化程度高是孕妇铅污染的保护性因素;居室附近有铅作业工厂是孕妇铅污染的危险因素;孕晚期由于骨铅的释放,孕妇血铅水平普遍增高。     

274例孕妇血铅水平及相关因素的探讨

目的:了解武汉市孕妇血铅水平及其影响因素。方法:将274例来院产检的孕妇分为早、中和晚孕3组进行问卷调查,并采用原子吸收光谱仪测定血铅值。结果:孕妇高铅血症发生率12.77%,孕期血铅呈动态变化,孕早、中和晚期分别为(62.25±20.29)μg/dl、(63.16±24.42)μg/dl和(67.19±26.85)μg/dl,差异有统计学意义(P<0.01)。孕妇血铅值高低与常吃膨化食品、使用化妆品、被动吸烟频数和食用乳制品、钙锌铁剂频数有关。多因素逐步回归分析筛选影响血铅值的因素是孕周、常吃膨化食品、被动吸烟。结论:现阶段武汉城区孕妇血铅水平处于可接受范围;健康教育、环境治理、调整膳食及养成良好的生活行为习惯是减少孕妇铅中毒的有效途径。     

大气PM2.5污染与孕妇血铅水平的关系

目的 了解大气PM2.5污染状况及与孕妇血铅水平的关系.方法 于2011年1-12月用PM2.5颗粒物采样器测定哈尔滨市道外区(污染区)和道里区(对照区)大气PM2.5浓度,以石墨炉原子吸收光谱法测定该地区169名孕产妇血铅值,应用多元逐步回归方法评价大气PM2.5与孕妇血铅水平之间的关系.结果 调查地区的非采暖期大气PM2.5浓度为(64.66±5.8) μg/m3,采暖期为(88.01±10.1) μgm3,超标率为89.5％和100.0％.污染区大气PM2.5浓度[(85.5±7.3)μg/m2]高于对照区[(61.5±5.0) μg/m3],差异有统计学意义(P＜0.01).孕妇血铅中位数为54.3 μg/L.多元逐步回归分析显示,用彩色餐具盛装食物、居住在大气PM2.5浓度较高的地区可能与孕妇血铅水平的升高有关(P＜0.05).结论 本次调查的孕妇血铅水平升高可能与大气PM2.5污染有关.     

右旋糖苷铁对孕妇和婴儿Hb含量影响的多因素分析

目的 探讨孕妇及婴儿贫血的防治方法.方法 将313例孕期满24周的孕妇分为3组.对照组:不服右旋糖苷铁;QD组:每日服右旋糖苷铁一次;QW组:每周服右旋糖苷铁一次.孕妇6项观察指标为:血红蛋白(Hb)、血清铁蛋白(SF)、游离红细胞原卟啉(FEP)、红细胞容积分布宽度(RDW)、平均红细胞容积(MCV)和贫血患病率.这些指标在观察前和观察后各测一次.2项婴儿观察指标为:血红蛋白(Hb)、贫血患病率.结果 孕妇观察前6项指标3组间比较,差异无显着性,但孕妇观察后6项指标3组间比较,差异有显着性,其中以QD组疗效最好.婴儿血红蛋白的均值以QD组最高.婴儿血红蛋白含量的主要影响因素为孕后期Hb含量和孕中期的MCV的含量.结论 怀孕中后期每日服用右旋糖苷铁对防治孕妇和婴儿贫血有重要作用.     

妊娠期TORCH筛查与妊娠结局探讨

目的了解本地区孕妇TORCH(弓形虫、风疹病毒、巨细胞病毒、单纯疱疹病毒)感染状况及其与不良妊娠结局之间的关系。方法应用ELISA法检测1047例孕妇血清中TORCH-IgM和TORCH-IgG。结果孕妇血清中TOXO-IgM阳性率为0.39%,RV-IgM阳性率为0.38%,CMV-IgM阳性率为0.67%,HSV-I-IgM阳性率为0.58%,HSV-Ⅱ-IgM阳性率为0.69%:本次不良妊娠结局孕妇TORCH-IgM阳性率明显高于正常妊娠者,两者差异有显著性(P<0.05)。结论孕妇应常规、追踪进行TORCH血清学检测:孕妇TORCH感染严重影响妊娠结局。     

Thyroid Hormone Levels of Pregnant Inuit Women and Their Infants Exposed to Environmental Contaminants

Background

An increasing number of studies have shown that several ubiquitous environmental contaminants possess thyroid hormone–disrupting capacities. Prenatal exposure to some of them, such as polychlorinated biphenyls (PCBs), has also been associated with adverse neurodevelopmental effects in infants.

Objectives

In this study we examined the relationship between exposure to potential thyroid hormone–disrupting toxicants and thyroid hormone status in pregnant Inuit women from Nunavik and their infants within the first year of life.

Methods

We measured thyroid hormone parameters [thyroid stimulating hormone (TSH), free thyroxine (fT₄), total triiodothyronine (T₃), thyroxine-binding globulin (TBG)] and concentrations of several contaminants [PCB-153, hydroxylated metabolites of PCBs (HO-PCBs), pentachlorophenol (PCP) and hexachlorobenzene (HCB)] in maternal plasma at delivery (n = 120), in umbilical cord plasma (n = 95), and in infant plasma at 7 months postpartum (n = 130).

Results

In pregnant women, we found a positive association between HO-PCBs and T₃ concentrations (β = 0.57, p = 0.02). In umbilical cord blood, PCB-153 concentrations were negatively associated with TBG levels (β = −0.26, p = 0.01). In a subsample analysis, a negative relationship was also found between maternal PCP levels and cord fT₄ concentrations in neonates (β = −0.59, p = 0.02). No association was observed between contaminants and thyroid hormones at 7 months of age.

Conclusion

Overall, there is little evidence that the environmental contaminants analyzed in this study affect thyroid hormone status in Inuit mothers and their infants. The possibility that PCP may decrease thyroxine levels in neonates requires further investigation.     

北京市对项目社区孕妇妊娠危险因素的知信行调查

目的了解北京市项目社区孕妇对妊娠危险因素知识的掌握水平、态度和行为(知信行)现状,为建立供需双方联动的高危妊娠管理模式提供依据。方法围绕孕妇的健康状况和需求,自行设计调查问卷,现场调查北京市4个项目社区的孕妇。结果北京市项目社区孕妇对于妊娠危险因素知识的合格率为63.5%,且与孕妇户口类别、丈夫职业和家庭月收入相关;态度合格率达到94.1%,且与孕妇的文化程度相关;主动就医合格率为61.4%,且与孕妇的目前居住状态相关。孕妇对妊娠危险因素的知识、态度和行为得分间存在正相关。结论北京市在高危妊娠管理中须关注重点人群,尤其是流动孕妇,同时尚须借力孕妇的社会支持体系,逐步提高孕妇的自主保健意识,最终形成供需双方联动的管理模式。     

Relationship Between Blood Lead Levels and Hematological Indices in Pregnant Women

Several studies have revealed a negative association between blood lead levels and hematological impairment. In this cross-sectional study, we examined the relationship between blood lead levels and hematological indices in 292 pregnant women from Durango, Mexico. Apparently healthy pregnant women, aged 14–41 years and at 3–41 weeks of gestation, were recruited between June 2007 and May 2008. Blood lead and hematological indices were measured. The mean blood lead was 2.79 ± 2.16 μg/dL, and lead levels ≥5 μg/dL were detected in 25 women (8.6%). Hemoglobin, hematocrit, and red blood cells count were significantly higher in pregnant women with a blood lead concentration of ≥5 μg/dL than the group with lower blood lead levels (p < .05). Mean corpuscular volume and mean corpuscular hemoglobin were not significantly related to lead levels. Hemoglobin and hematocrit showed a non-significant positive correlation with blood lead, but the correlation between red blood cell count and blood lead levels was statistically significant (r = 0.185, p = .002). The findings suggest that a positive association between blood lead and some hematological indices may occur at relatively low blood lead concentration (mean < 5 μg/dL).     

Serum DDT and DDE Levels in Pregnant Women of Chiapas,Mexico

The authors measured the main ingredients of technical DDT (1,1,1-trichloro-2,2-bis(p-chlorophenyl [p,p[icaron]-DDT]) and its principal metabolite, 1,1-dichloro-2,2-bis (p-chlorophenyl)ethylene [p,p[icaron]-DDE]) in serum collected from 52 pregnant women in Tapachula, Chiapas, Mexico in 1998. The median lipid-adjusted serum levels for the women were 676 ng/g p,p[icaron]-DDT (range: 56–23,169 ng/g) and 4,843 ng/g p,p[icaron]-DDE (range: 113–41, 964 ng/g). In regression analysis, serum DDT and DDE increased with age (test for trend, p = .022) but decreased with total lactation (test for trend, p < .001). Residence in a house that had ever been sprayed for malaria control was also related to serum DDT and DDE. This study provides evidence of high-level exposure to DDT and DDE among pregnant women living in Chiapas, Mexico, despite countrywide restrictions on its use at the time.     

孕期妇女低水平铅暴露对婴儿听觉发育的影响

目的 探讨孕妇孕期低水平铅暴露对婴儿听觉发育的可能影响.方法 于孕妇妊娠中期及产时采静脉血检测血铅水平,婴儿断脐后取脐血测血铅,血铅水平作为孕期铅暴露状况的指标.至婴儿6月龄时行脑干听觉诱发电位(Brainstem Auditory Evoked Potentials BAEP)检测,作为铅暴露对婴儿听功能影响的研究指标.结果 (1)母孕中期血铅水平为0.289±0.050μmol/L,产时血铅0.242±0.049μmol/L,脐血铅:0.197～0.051μmol/L.(2)6月龄婴儿右耳BAEP的Ⅰ、Ⅲ、Ⅴ波潜伏期与脐血铅水平呈正相关.以脐血铅水平0.242μmol/L为界,将婴儿分为高、低铅暴露组,高铅暴露组婴儿右耳BAEPI、Ⅴ波潜伏期明显长于低铅暴露组.通过多元线性回归分析,脐血铅值均进入了关于右耳BAEPI、Ⅲ、Ⅴ波潜伏期的方程.结论 孕期低水平铅暴露对早期婴儿的听觉发育有不利影响.