McDiarmid Melissa A, Gardiner Paula M, Jack Brian W
Occupational Health Program, University of Maryland, MD, USA.
Am J Obstet Gynecol. 2008 Dec;199(6 Suppl 2):S357-61. doi: 10.1016/j.ajog.2008.10.044.
Environmental origins of disease risk and harm to health have been increasingly acknowledged for numerous outcomes, in both adult and pediatric populations. Adverse reproductive and developmental effects have also been linked to environmental exposures. In addition to the current queries about a patient's alcohol and smoking history, key determinants of a future pregnancy outcome should also be elicited during the preconception visit. These determinants include: (1) mercury intake via fish consumption; (2) nitrate exposure from well water sources; (3) exposure to chemical, physical, or biologic hazards on the job; and (4) lead and other toxic exposures--possibly from hobbies or the use of lead-glazed dinnerware in the home. Eliciting a detailed environmental history permits tailored recommendations to optimize the woman's health and that of her future pregnancy.
疾病风险和对健康的危害的环境起源，在成人和儿童群体中，已被越来越多地认可为众多结果的原因。不良的生殖和发育影响也与环境暴露有关。除了目前询问患者的饮酒和吸烟史外，在孕前检查时还应了解未来妊娠结局的关键决定因素。这些决定因素包括：（1）通过食用鱼类摄入汞；（2）来自井水水源的硝酸盐暴露；（3）工作中接触化学、物理或生物危害；（4）铅和其他有毒暴露——可能来自爱好或家中使用含铅釉面餐具。详细询问环境史有助于给出针对性的建议，以优化女性及其未来妊娠的健康状况。
