Langlois Peter H, Hoyt Adrienne T, Lupo Philip J, Lawson Christina C, Waters Martha A, Desrosiers Tania A, Shaw Gary M, Romitti Paul A, Lammer Edward J
Texas Center for Birth Defects Research and Prevention, Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas 78714-9347, USA.
Birth Defects Res A Clin Mol Teratol. 2012 Sep;94(9):693-700. doi: 10.1002/bdra.23045. Epub 2012 Jul 17.
This study evaluated whether there is an association between maternal occupational exposure to polycyclic aromatic hydrocarbons (PAHs) and neural tube defects (NTDs) in offspring. This is the first such study of which the authors are aware.
Data were analyzed from 1997 to 2002 deliveries in the National Birth Defects Prevention Study, a large population-based case-control study in the United States. Maternal interviews yielded information on jobs held in the month before through 3 months after conception. Three industrial hygienists blinded to case or control status assessed occupational exposure to PAHs. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using unconditional logistic regression.
Of the 520 mothers of children with NTDs, 5.0% were classified as exposed to occupational PAHs, as were 3.5% of the 2989 mothers of controls. The crude OR for PAH exposure was 1.43 (95% CI, 0.92-2.22) for any NTD and 1.71 (95% CI, 1.03-2.83) for spina bifida. Adjusted ORs were smaller in magnitude and not significant. Among women who were normal weight or underweight, the crude OR for spina bifida was 3.13 (95% CI, 1.63-6.03) and adjusted OR was 2.59 (95% CI, 1.32-5.07). Based on estimated cumulative exposure, a statistically significant dose-response trend was observed for spina bifida; however, it was attenuated and no longer significant after adjustment.
Maternal occupational exposure to PAHs may be associated with increased risk of spina bifida in offspring among women who are normal weight or underweight. Other comparisons between PAHs and NTDs were consistent with no association.
本研究评估了母亲职业性接触多环芳烃（PAHs）与后代神经管缺陷（NTDs）之间是否存在关联。据作者所知，这是首次此类研究。
对美国一项基于人群的大型病例对照研究——国家出生缺陷预防研究中1997年至2002年分娩的数据进行分析。母亲访谈提供了受孕前1个月至受孕后3个月所从事工作的信息。3名对病例或对照状态不知情的工业卫生学家评估职业性PAHs暴露情况。使用无条件逻辑回归估计粗比值比（ORs）和调整后的比值比以及95%置信区间（CIs）。
在520名神经管缺陷患儿的母亲中，5.0%被归类为职业性接触PAHs，在2989名对照儿童的母亲中这一比例为3.5%。任何神经管缺陷的PAHs暴露粗比值比为1.43（95%CI，0.92 - 2.22），脊柱裂的粗比值比为1.71（95%CI，1.03 - 2.83）。调整后的比值比数值较小且无统计学意义。在体重正常或体重不足的女性中，脊柱裂的粗比值比为3.13（95%CI，1.63 - 6.03），调整后的比值比为2.59（95%CI，1.32 - 5.07）。基于估计的累积暴露量，观察到脊柱裂存在统计学显著的剂量反应趋势；然而，调整后该趋势减弱且不再显著。
体重正常或体重不足的女性，其职业性接触PAHs可能与后代脊柱裂风险增加有关。PAHs与神经管缺陷之间的其他比较结果表明两者无关联。
