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先天性心脏病与父母职业性接触化学制品。

Congenital heart defects and parental occupational exposure to chemicals.

机构信息

Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, 3000 CA Rotterdam, The Netherlands.

出版信息

Hum Reprod. 2012 May;27(5):1510-7. doi: 10.1093/humrep/des043. Epub 2012 Feb 22.

Abstract

BACKGROUND

Congenital heart defects (CHDs) are the most common major malformations in newborns. In this study we examined the associations between the occurrence of CHDs in children and periconceptional occupational parental exposures to chemicals.

METHODS

In an age-matched case-control study with standardized data collection at c. 15 months after birth, 424 mothers and 421 fathers of a child with CHD and 480 mothers and 477 fathers of a non-malformed child, filled out questionnaires on periconceptional general and job characteristics. A job exposure matrix, which links the information on job title and a description of work tasks to an expert judgement on exposure to chemicals in the workplace, was used.

RESULTS

The overall prevalence of occupational exposure to chemicals was 5.0 in cases and 6.2% in controls for mothers [odds ratio (OR) adjusted = 0.92; 95% confidence interval (CI): 0.26-3.25], while 22.3 and 15.9% for fathers, respectively (OR adjusted = 1.23; 95% CI: 0.39-3.91). No association of maternal occupational exposure to chemicals with risk of CHDs was found. Paternal exposure to phthalates was associated with a higher incidence of CHDs in general (OR adjusted = 2.08; 95% CI: 1.27-3.40). Paternal exposure to phthalates was associated with perimembranous ventricular septal defect (OR adjusted = 2.84; 95% CI: 1.37-5.92), to polychlorinated compounds with atrioventricular septal defect (OR adjusted = 4.22; 95% CI: 1.23-14.42) and to alkylphenolic compounds with coarctation of the aorta (OR adjusted = 3.85; 95% CI: 1.17-12.67).

CONCLUSIONS

Periconceptional paternal (but not maternal) occupational exposure to certain chemicals is associated with an increased risk of CHDs in children. The results, however, must be interpreted cautiously as exposure probabilities are a crude measure of exposure.

摘要

背景

先天性心脏病(CHD)是新生儿中最常见的重大畸形。在这项研究中,我们研究了儿童 CHD 的发生与围孕期父母职业性接触化学物质之间的关系。

方法

在一项年龄匹配的病例对照研究中,在出生后约 15 个月进行标准化数据收集,共有 424 名 CHD 患儿的母亲和 421 名父亲,以及 480 名非畸形患儿的母亲和 477 名父亲填写了围孕期一般和工作特征问卷。使用职业暴露矩阵,该矩阵将职业头衔信息和工作任务描述与工作场所接触化学物质的专家判断联系起来。

结果

母亲中职业性接触化学物质的总体流行率为病例组 5.0%,对照组 6.2%(调整后的比值比 [OR] = 0.92;95%置信区间 [CI]:0.26-3.25),而父亲中分别为 22.3%和 15.9%(调整后的 OR = 1.23;95%CI:0.39-3.91)。母亲职业性接触化学物质与 CHD 风险之间没有关联。父亲接触邻苯二甲酸酯与 CHD 的总体发生率较高相关(调整后的 OR = 2.08;95%CI:1.27-3.40)。父亲接触邻苯二甲酸酯与膜周室间隔缺损(调整后的 OR = 2.84;95%CI:1.37-5.92)、多氯化合物与房室间隔缺损(调整后的 OR = 4.22;95%CI:1.23-14.42)和烷基酚化合物与主动脉缩窄(调整后的 OR = 3.85;95%CI:1.17-12.67)有关。

结论

围孕期父亲(而非母亲)的职业性接触某些化学物质与儿童 CHD 的风险增加有关。然而,由于暴露概率是暴露的粗略衡量标准,因此必须谨慎解释这些结果。

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