Garlantézec R, Monfort C, Rouget F, Cordier S
Inserm U625, GERHM, Univ Rennes I, Campus de Beaulieu, Rennes F-35042, France.
Occup Environ Med. 2009 Jul;66(7):456-63. doi: 10.1136/oem.2008.041772.
To study the relations between maternal occupational exposure to solvents during pregnancy and the risk of congenital malformations.
A prospective population-based cohort, specifically designed to study the impact of maternal exposure to solvents on the risk of congenital malformations, began in 2002 in three districts of Brittany (France). 3421 pregnant women were recruited until the end of 2005 by physicians before 19 weeks of gestation and followed through birth. Information on pregnancy outcomes was obtained from the hospital. Occupational exposure to solvents at the beginning of pregnancy was assessed from the women's self-reported occupational exposures at inclusion and from a job-exposure matrix (JEM). Sociodemographic characteristics, lifestyle factors, medical history, diseases during pregnancy were obtained at inclusion and from hospital records. Analyses were restricted to working women (n = 3005). Logistic regressions were used to adjust for potential confounders.
30.2% of the working women declared regular exposure to at least one product that may contain solvents. 21.3% of them were classified at least in the medium exposure category using the JEM. Occupations mainly classified as exposed by both assessment methods were hairdressers, nurses' aides, nurses and chemists/biologists. Significant associations were found between major congenital malformations and maternal occupational exposure to solvents, assessed by both self-report odds ratio (OR = 2.48, 95% CI 1.4 to 4.4 for regular exposure vs no exposure) and the JEM (OR = 3.48, 95% CI 1.4 to 8.4 for highest level of exposure vs no exposure). A significant dose-response trend was observed with both assessment methods. Several subgroups of major malformations were associated with maternal exposure to solvents (oral clefts, urinary malformations and male genital malformations).
This study provides further evidence of an association between exposure to solvents during pregnancy and the risk of major malformations.
研究孕期母亲职业性接触溶剂与先天性畸形风险之间的关系。
一项基于人群的前瞻性队列研究于2002年在法国布列塔尼的三个地区启动，该研究专门设计用于研究母亲接触溶剂对先天性畸形风险的影响。在妊娠19周前，由医生招募了3421名孕妇，直至2005年底，并跟踪至分娩。妊娠结局信息来自医院。根据孕妇纳入时自我报告的职业接触情况以及工作接触矩阵（JEM）评估孕期开始时的职业性接触溶剂情况。纳入时以及从医院记录中获取社会人口学特征、生活方式因素、病史、孕期疾病等信息。分析仅限于职业女性（n = 3005）。采用逻辑回归对潜在混杂因素进行校正。
30.2%的职业女性宣称经常接触至少一种可能含有溶剂的产品。使用JEM将其中21.3%的女性至少归类为中度接触类别。两种评估方法均主要归类为接触的职业有美发师、护士助理、护士以及化学师/生物学家。通过自我报告优势比（经常接触与未接触相比，OR = 2.48，95%CI为1.4至4.4）和JEM（最高接触水平与未接触相比，OR = 3.48，95%CI为1.4至8.4）评估发现，主要先天性畸形与母亲职业性接触溶剂之间存在显著关联。两种评估方法均观察到显著的剂量反应趋势。主要畸形的几个亚组与母亲接触溶剂有关（唇腭裂、泌尿系统畸形和男性生殖器畸形）。
本研究进一步证明了孕期接触溶剂与主要畸形风险之间存在关联。
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