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新生儿先天性异常与经常接触有机溶剂的职业女性——一项基于登记的前瞻性研究。

Congenital anomalies in newborns to women employed in jobs with frequent exposure to organic solvents--a register-based prospective study.

机构信息

Helse UMB, Institutt for husdyr og akvakulturvitenskap, Universitetet for miljø- og biovitenskap, Ås, Norway.

出版信息

BMC Pregnancy Childbirth. 2011 Oct 27;11:83. doi: 10.1186/1471-2393-11-83.

Abstract

BACKGROUND

The foetal effects of occupational exposure to organic solvents in pregnancy are still unclear. Our aim was to study the risk of non-chromosomal congenital anomalies at birth in a well-defined population of singletons born to women employed as painters and spoolers in early pregnancy, compared to women in non-hazardous occupations.

METHOD

The study population for this prospective cohort study was singleton newborns delivered to working mothers in the industrial community of Mončegorsk in the period 1973-2005. Occupational information and characteristics of the women and their newborns was obtained from the local population-based birth register.

RESULTS

The 597 women employed as painters, painter-plasterers or spoolers had 712 singleton births, whereof 31 (4.4%) were perinatally diagnosed with 37 malformations. Among the 10 561 newborns in the group classified as non-exposed, 397 (3.9%) had one or more malformations. The overall prevalence in the exposed group was 520/10 000 births [95% confidence limits (CL): 476, 564], and 436/10 000 births (95% CL: 396, 476) in the unexposed. Adjusted for young maternal age, smoking during pregnancy, maternal congenital malformation and year of birth, the odds ratio (OR) was 1.24 (95% CL: 0.85, 1.82); for multiple anomalies it was 1.54 (95% CL: 0.66, 3.59).The largest organ-system specific difference in prevalence between the two groups was observed for malformations of the circulatory system: 112/10 000 (95% CL: 35, 190) in the exposed group, and 42/10 000 (95% CL: 29, 54) in the unexposed, with an adjusted OR of 2.03 (95% CL: 0.85, 4.84). The adjusted ORs for malformations of the genital organs and musculoskeletal system were 2.24 (95% CI: 0.95, 5.31) and 1.12 (95% CI: (0.62, 2.02), respectively.

CONCLUSION

There appeared to be a higher risk of malformations of the circulatory system and genital organs at birth among newborns to women in occupations with organic solvent exposure during early pregnancy (predominantly employed as painters). However, the findings were not statistically conclusive. Considering that these two categories of malformations are not readily diagnosed perinatally, the difference in prevalence between the exposed and unexposed may have been underestimated.

摘要

背景

目前,人们对于孕妇在妊娠期接触有机溶剂对胎儿的影响仍不明确。本研究旨在探讨早孕期职业暴露于有机溶剂的女性所生单胎婴儿的非染色体先天性畸形的发病风险,与非高危职业女性所生婴儿进行对比。

方法

本前瞻性队列研究的研究人群为 1973 年至 2005 年期间在莫尔茨克工业社区工作的母亲所生的单胎新生儿。职业信息以及母亲和新生儿的特征信息均来自于当地的人口基础出生登记处。

结果

597 名从事画家、油漆工或绕线工职业的女性共分娩了 712 例单胎新生儿,其中 31 例(4.4%)围产期被诊断患有 37 种畸形。在未暴露组的 10561 名新生儿中,有 397 例(3.9%)患有一种或多种畸形。暴露组的整体患病率为 520/10000 例活产儿(95%置信区间(CI):476,564),未暴露组为 436/10000 例活产儿(95%CI:396,476)。校正了母亲年龄较小、孕期吸烟、母亲先天性畸形和出生年份后,比值比(OR)为 1.24(95%CI:0.85,1.82);对于多发性畸形,OR 为 1.54(95%CI:0.66,3.59)。两组之间最大的器官系统特异性患病率差异见于循环系统畸形:暴露组为 112/10000(95%CI:35,190),未暴露组为 42/10000(95%CI:29,54),调整后的 OR 为 2.03(95%CI:0.85,4.84)。生殖器官和肌肉骨骼系统畸形的调整比值比分别为 2.24(95%CI:0.95,5.31)和 1.12(95%CI:0.62,2.02)。

结论

早孕期接触有机溶剂的女性所生新生儿存在更高的先天性心血管系统畸形和生殖器官畸形风险(主要是画家)。然而,研究结果尚无统计学意义。考虑到这两类畸形不易在围产期被诊断,暴露组和未暴露组的患病率差异可能被低估了。

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