Program in Public Health and Department of Epidemiology, College of Health Sciences, University of California, Irvine, California, USA.
Sci Total Environ. 2010 May 1;408(11):2312-8. doi: 10.1016/j.scitotenv.2010.02.028. Epub 2010 Mar 9.
Polycyclic aromatic hydrocarbons (PAHs) are formed during incomplete burning of fossil fuels, wood, and tobacco products. High PAH exposure has been associated with low birth weight, intrauterine growth restriction, and preterm birth, but little is known about its impact on adverse outcomes in early pregnancy such as in-utero fetal death.
To examine associations between exposure to PAHs and missed abortion in which the embryo has died but a miscarriage has not yet occurred during early pregnancy in a Chinese population in Tianjin.
A case-control study was conducted from April to November, 2007 in Tianjin, China. Cases experienced a missed abortion while controls underwent elective abortions before 14weeks of pregnancy. Eighty-one cases were recruited from four hospitals, with the same number of controls matched on hospital, maternal age (+/-8years), gravidity (1 or >1), and gestational age (+/-30days). Two maternal measures of PAH exposures were obtained based on benzo[a]pyrene (BaP) DNA adducts in 1) aborted tissues and 2) maternal blood (for a subset of subjects). In addition, proxy measures for PAH exposures from different sources were derived from maternal interviews.
In conditional logistic regression analyses, we estimated more than 4-fold increase in risk of having experienced a missed abortion in women with above the median levels of blood BaP-DNA adducts (adjusted OR=4.27; 95% CI, 1.41-12.99); but no increase with adduct levels in aborted tissues (adjusted OR=0.76; 95% CI, 0.37-1.54). BaP-DNA adduct levels in maternal blood and aborted tissues were poorly correlated (r=-0.12; n=102). Missed abortion risk also was higher among women reporting traffic congestion near the residence, commuting by walking, and performing regular cooking activities during pregnancy.
High levels of maternal PAH exposures may contribute to an increased risk of experiencing a missed abortion during early pregnancy.
多环芳烃（PAHs）是化石燃料、木材和烟草产品不完全燃烧时形成的。高浓度的 PAH 暴露与低出生体重、宫内生长受限和早产有关，但对于其对中国天津人群早孕期间不良结局（如宫内胎儿死亡）的影响知之甚少。
在天津的中国人群中，研究多环芳烃（PAHs）暴露与稽留流产（胚胎已死亡但流产尚未发生）之间的关系。
本病例对照研究于 2007 年 4 月至 11 月在中国天津进行。病例组经历了稽留流产，而对照组则在妊娠 14 周前进行了选择性流产。从四家医院招募了 81 例病例，按医院、产妇年龄（±8 岁）、孕次（1 次或>1 次）和孕龄（±30 天）匹配了相同数量的对照组。基于苯并[a]芘（BaP）DNA 加合物，从 1）流产组织和 2）母亲血液（对于部分研究对象）中获得了 2 项母体 PAH 暴露测量值。此外，还从母亲访谈中得出了不同来源的 PAH 暴露的替代测量值。
在条件 logistic 回归分析中，我们估计血液中 BaP-DNA 加合物水平高于中位数的女性发生稽留流产的风险增加了 4 倍以上（调整后的 OR=4.27；95%CI，1.41-12.99）；但在流产组织中加合物水平无升高（调整后的 OR=0.76；95%CI，0.37-1.54）。母亲血液和流产组织中的 BaP-DNA 加合物水平相关性较差（r=-0.12；n=102）。报告居住附近交通拥堵、步行上下班和怀孕期间经常做饭的女性发生稽留流产的风险也较高。
母体 PAH 暴露水平升高可能会增加早孕期间发生稽留流产的风险。
