Odland J O, Nieboer E, Romanova N, Thomassen Y, Brox J, Lund E
Institute of Community Medicine, University of Tromsø, Norway.
Acta Obstet Gynecol Scand. 1999 Aug;78(7):605-14.
This project is part of an assessment of the impact of environmental factors on human health in the Kola Peninsula of Russia and the neighboring arctic area of Norway. Pregnant women and their newborns were studied to explore a relationship between maternal status of essential metals and birth weight.
Life-style information and serum specimens were collected from at least 50 consecutive mother-infant pairs from hospital delivery departments in three Russian and three Norwegian communities (N=151 and 167, respectively). Pregnancy outcomes were verified by consulting medical records. Copper, selenium and zinc in serum were determined by atomic absorption spectrometry and ferritin by an automated analyzer method.
Mean birth weight and child's body mass index (BMIC) were significantly lower in the Russian group (p<0.001), with or without adjustment for gestational age. Copper, iron (as ferritin) and selenium serum concentrations were in the normal range, while zinc levels in both countries were mostly below the lower limit (10.8 micromol/L) of reported reference intervals. A positive correlation between zinc and birth weight or BMIC was only observed for concentrations exceeding 10.8 micromol/L. Analysis by quartiles showed that maternal urinary creatinine and birth weight were negatively correlated (p=0.001). The influence of the different elements on BMIC, grouped by quartiles, was significantly positive only for selenium (p=0.03) and ferritin (p=0.02), while there was no significant relationship for copper or zinc. Adjustment of birth weight and BMIC for gestational age did not alter substantially the various associations indicated.
With the exception of zinc, the mineral status of delivering women in arctic and sub-arctic regions of Norway and western Russia appears to be adequate. The significantly lower BMIC for the Russian group suggests the likely occurrence of nutritional deficiencies during pregnancy in Russia. However, the significant contribution of a country factor in the predictive model implies that the maternal serum trace-element concentrations explored in this study are incomplete indicators of fetal undernourishment.
本项目是对俄罗斯科拉半岛及挪威邻近北极地区环境因素对人类健康影响评估的一部分。对孕妇及其新生儿进行了研究，以探讨必需金属的母体状况与出生体重之间的关系。
从俄罗斯和挪威的三个社区的医院分娩科室连续收集了至少50对母婴的生活方式信息和血清样本（分别为N = 151和167）。通过查阅病历核实妊娠结局。血清中的铜、硒和锌通过原子吸收光谱法测定，铁蛋白通过自动分析仪方法测定。
无论是否调整胎龄，俄罗斯组的平均出生体重和儿童体重指数（BMIC）均显著较低（p < 0.001）。铜、铁（以铁蛋白形式）和硒的血清浓度在正常范围内，而两国的锌水平大多低于报告参考区间的下限（10.8微摩尔/升）。仅在锌浓度超过10.8微摩尔/升时，才观察到锌与出生体重或BMIC之间存在正相关。四分位数分析表明，母体尿肌酐与出生体重呈负相关（p = 0.001）。按四分位数分组，不同元素对BMIC的影响仅对硒（p = 0.03）和铁蛋白（p = 0.02）呈显著正相关，而铜或锌则无显著关系。对出生体重和BMIC进行胎龄调整后，并未实质性改变所表明的各种关联。
除锌外，挪威和俄罗斯西部北极及亚北极地区分娩妇女的矿物质状况似乎充足。俄罗斯组显著较低的BMIC表明俄罗斯孕妇在孕期可能存在营养缺乏。然而，预测模型中一个国家因素的显著贡献意味着本研究中探索的母体血清微量元素浓度是胎儿营养不良的不完整指标。
