Hospital Dr. Ernesto Accame, Ing Quesnel S/N°, Allen (8328), Río Negro, Argentina.
Ecotoxicol Environ Saf. 2012 Jun;80:280-7. doi: 10.1016/j.ecoenv.2012.03.008. Epub 2012 Apr 10.
In utero exposure is the first point of contact with environmental xenobiotics that may affect the maternal-placental-fetal balance. Considering that maternal pathophysiological changes affect intrauterine development, this pilot study was conducted to address how environmental exposure to organophosphate pesticides (OPs) during pregnancy may contribute to maternal endocrine disruption and disturbed hepatic function. A prospective study was carried out with pregnant women (n=97) living in a rural area of the Rio Negro province where OPs are intensively applied throughout 6 months of the year. Blood samples were obtained and biomarkers of OPs exposure (cholinesterases and β-glucuronidase), cortisol (CT) and progesterone (PG) levels, as well as glycemia, were determined. Parameters of liver injury were assayed by measuring aspartate aminotransferase (AST) and alanine aminotransferase (ALT); liver function was assayed by measuring albumin. Biomonitoring carried out during the pre-spraying period (PreS) and spraying period (SP) showed that the population studied was exposed to OPs, proven by the fact that plasma (PCh) and erythrocyte cholinesterase (AChE) decreased very significantly (p<0.01) during SP. CT values increased very significantly (p<0.01) in the first trimester of pregnancy during SP with respect to PreS. Individual values above the upper limit of the CT and PG reference range were found both in PreS and SP. This finding could be associated with changes in hormone metabolism pathways produced by OPs exposure. During the second trimester of pregnancy there were increases in ALT values and the AST/ALT ratio in SP, suggesting subclinical hepatotoxicity. In SP, glycemia was unchanged while albuminemia increased. Although anthropometric newborn parameters and pregnancy alterations were within normal values for the general population, the increase in CT in the maternal compartment may lead to impaired newborn health later in life.
宫内暴露是接触环境外来化合物的第一个接触点，这些化合物可能会影响母体-胎盘-胎儿的平衡。考虑到母体的病理生理变化会影响宫内发育，因此进行了这项前瞻性研究，以探讨怀孕期间接触有机磷农药 (OPs) 如何导致母体内分泌失调和肝功能紊乱。该研究对居住在里奥内格罗省农村地区的 97 名孕妇进行了前瞻性研究，该地区在一年中的 6 个月内密集使用 OPs。采集血样，测定 OPs 暴露标志物（胆碱酯酶和β-葡糖苷酸酶）、皮质醇 (CT) 和孕酮 (PG) 水平以及血糖。通过测量天冬氨酸氨基转移酶 (AST) 和丙氨酸氨基转移酶 (ALT) 来测定肝损伤参数；通过测量白蛋白来测定肝功能。在预喷期 (PreS) 和喷期 (SP) 进行的生物监测表明，研究人群接触到了 OPs，这一点通过血浆 (PCh) 和红细胞乙酰胆碱酯酶 (AChE) 在 SP 期间显著降低得到证实（p<0.01）。与 PreS 相比，SP 期间妊娠早期 CT 值显著升高（p<0.01）。在 PreS 和 SP 时均发现 CT 和 PG 参考范围上限以上的个体值。这一发现可能与 OPs 暴露导致的激素代谢途径变化有关。在妊娠中期，SP 时 ALT 值和 AST/ALT 比值增加，提示存在亚临床肝毒性。在 SP 期间，血糖保持不变，而白蛋白血症增加。尽管新生儿的人体测量参数和妊娠变化均在一般人群的正常范围内，但母体 CT 值的增加可能会导致新生儿在以后的生活中健康受损。
