Hujoel P P, Lydon-Rochelle M, Bollen A M, Woods J S, Geurtsen W, del Aguila M A
Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195-7475, USA.
Am J Epidemiol. 2005 Apr 15;161(8):734-40. doi: 10.1093/aje/kwi100.
Several European countries have guidelines suggesting that women should not receive mercury-containing dental amalgam fillings during pregnancy. One concern raised by several studies is that mercury exposure during pregnancy may lead to decreased birth weight. A population-based, case-control study was designed to investigate whether placement of mercury-containing fillings in 1993-2000 during pregnancy increased the low-birth-weight risk. Cases and controls were sampled from enrollees of a dental insurance plan with live singleton births in Washington State; 1,117 women with low-birth-weight infants (< 2,500 g) were compared with a random sample of 4,468 women with infants weighing 2,500 g or more. The results indicated that 13% of a dentally insured population had one or more restorative procedures during pregnancy that, regardless of chemical composition, did not increase the low-birth-weight risk (odds ratio = 0.96, 95% confidence interval: 0.88, 1.05). The 4.9% of the women (n = 249) who had at least one mercury-containing amalgam filling during pregnancy were not at an increased risk for a low-birth-weight infant (odds ratio = 0.75, 95% confidence interval: 0.45, 1.26) and neither were women who had 4-11 amalgam fillings placed (odds ratio = 1.00, 95% confidence interval: 0.27, 3.68). This study found no evidence that mercury-containing dental fillings placed during pregnancy increased low-birth-weight risk.
几个欧洲国家的指南建议,女性在怀孕期间不应接受含汞的牙科汞合金填充物。多项研究提出的一个担忧是,孕期接触汞可能导致出生体重下降。一项基于人群的病例对照研究旨在调查1993年至2000年期间孕期放置含汞填充物是否会增加低出生体重风险。病例和对照样本取自华盛顿州一项有单胎活产记录的牙科保险计划的参保者;将1117名低出生体重婴儿(<2500克)的母亲与随机抽取的4468名婴儿体重2500克或以上的母亲进行比较。结果表明,在有牙科保险的人群中,13%的女性在孕期进行了一项或多项修复治疗,无论填充物的化学成分如何,均未增加低出生体重风险(优势比=0.96,95%置信区间:0.88,1.05)。4.9%的女性(n=249)在孕期至少有一颗含汞合金填充物,其生出低出生体重婴儿的风险并未增加(优势比=0.75,95%置信区间:0.45,1.26),放置4 - 11颗汞合金填充物的女性也是如此(优势比=1.00,95%置信区间:0.27,3.68)。该研究没有发现证据表明孕期放置含汞牙科填充物会增加低出生体重风险。