Zhang J, Cai W W, Lee D J
Department of Maternal and Child Health, Shanghai Medical University, Peoples Republic of China.
Am J Ind Med. 1992;21(3):397-408. doi: 10.1002/ajim.4700210312.
This study examined the association between exposure to occupational hazards and pregnancy outcomes using data from a case-control study conducted in 29 hospitals in Shanghai, China. The sample included 1,875 perinatal deaths and newborns with birth defects and the same number of controls. Information on mother's exposure to occupational radiation, chemicals, noise, and pesticides was investigated. Logistic regression analysis controlling for potential confounders showed that exposure to radiation before/during pregnancy was associated with antepartum fetal death, birth defects, small-for-gestational-age (SGA), and threatened abortion. Exposure to chemicals before/during pregnancy was associated with antepartum fetal death, early neonatal death, birth defects, preterm birth, and threatened abortion. Women exposed to pesticides during pregnancy had an increased risk of SGA and threatened abortion. Exposure to occupational noise during pregnancy increased the risk of antepartum fetal death. Furthermore, higher than expected numbers of congenital anomalies in the central nervous system (CNS) were identified among women exposed to chemicals before pregnancy and to pesticides during the first trimester of pregnancy. No significant association was found between occupational exposure and intrapartum fetal death. Although recall bias may be possible in our study, the findings encourage further research.
本研究利用在中国上海29家医院开展的一项病例对照研究的数据,调查了职业危害暴露与妊娠结局之间的关联。样本包括1875例围产期死亡和出生缺陷新生儿以及相同数量的对照。对母亲暴露于职业辐射、化学物质、噪声和农药的情况进行了调查。在控制潜在混杂因素的逻辑回归分析中,结果显示孕期前/孕期暴露于辐射与产前胎儿死亡、出生缺陷、小于胎龄儿(SGA)和先兆流产有关。孕期前/孕期暴露于化学物质与产前胎儿死亡、早期新生儿死亡、出生缺陷、早产和先兆流产有关。孕期接触农药的女性发生SGA和先兆流产的风险增加。孕期暴露于职业噪声会增加产前胎儿死亡的风险。此外,在孕期前接触化学物质且在孕早期接触农药的女性中,中枢神经系统(CNS)先天性异常的数量高于预期。未发现职业暴露与产时胎儿死亡之间存在显著关联。尽管本研究可能存在回忆偏倚,但这些发现鼓励进一步开展研究。