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产前铅暴露与婴儿血铅水平的关系。

Relationship between prenatal lead exposure and infant blood lead levels.

机构信息

Environmental Epidemiology and Disease Registries Section, Texas Department of State Health Services, P.O. Box 149347, Austin, TX 78714-9347, USA.

出版信息

Matern Child Health J. 2012 Oct;16(7):1518-24. doi: 10.1007/s10995-011-0917-3.

Abstract

Recent literature has shown that analyzing newborn dried blood spots (DBS) may be effective in assessing some prenatal environmental exposures, such as exposure to lead. The purpose of this study was to evaluate the relationship between prenatal exposure to lead (as measured by newborn DBS results) and blood lead levels (BLLs) in infants 6 months of age or younger, using public health registry data for infants born in Texas from July 2002 through July 2006. The Texas Child Lead Registry (TCLR) was used to identify infants with documented elevated BLLs of 10 μg/dL or higher as well as infants with documented low BLLs. BLLs for these children were compared to their corresponding newborn DBS results using Pearson correlation coefficients and exact logistic regression models. Overall, a significant but weak positive correlation was found between infant BLLs and corresponding newborn DBS lead levels (r = 0.48). However, the odds of an infant with an elevated newborn DBS lead level having an elevated BLL at 6 months of age or younger were much greater than for an infant with a low newborn DBS lead level of <5 μg/dL (adjusted odds ratio 27.95, 95% CI: 5.52-277.28). Although an association was observed between newborn DBS lead levels and BLLs in infants tested between 0 to 6 months of age, our findings suggest that prenatal exposure may not be the only significant source of lead exposure for infants ≤6 months of age.

摘要

最近的文献表明,分析新生儿干血斑(DBS)可能有助于评估某些产前环境暴露,如铅暴露。本研究旨在利用 2002 年 7 月至 2006 年 7 月德克萨斯州出生的婴儿公共卫生登记数据,评估新生儿 DBS 检测结果(反映产前铅暴露)与 6 个月或以下婴儿血铅水平(BLL)之间的关系。使用德克萨斯州儿童铅登记处(TCLR)识别 BLL 为 10μg/dL 或更高的记录有升高的 BLL 的婴儿,以及记录有低 BLL 的婴儿。使用 Pearson 相关系数和精确逻辑回归模型,将这些儿童的 BLL 与相应的新生儿 DBS 结果进行比较。总体而言,婴儿 BLL 与相应的新生儿 DBS 铅水平之间存在显著但较弱的正相关(r=0.48)。然而,新生儿 DBS 铅水平升高的婴儿在 6 个月或以下时 BLL 升高的几率远高于新生儿 DBS 铅水平<5μg/dL 的婴儿(调整比值比 27.95,95%CI:5.52-277.28)。尽管在 0 至 6 个月龄之间进行检测的婴儿中观察到新生儿 DBS 铅水平与 BLL 之间存在关联,但我们的研究结果表明,产前暴露可能不是 6 个月或以下婴儿铅暴露的唯一重要来源。

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