Am J Epidemiol. 2014 Mar 1;179(5):536-44. doi: 10.1093/aje/kwt313. Epub 2014 Jan 8.
Persistent organic pollutants have not been conclusively associated with length of gestation or with preterm birth. Chlordecone is an organochlorine pesticide that has been extensively used to control the banana root borer population in the French West Indies. Data from the Timoun Mother-Child Cohort Study conducted in Guadeloupe between 2004 and 2007 were used to examine the associations of chlordecone concentrations in maternal plasma with the length of gestation and the rate preterm birth in 818 pregnant women. Data were analyzed using multivariate linear regression for length of gestation and a Cox model for preterm birth. The median plasma chlordecone concentration was 0.39 µg/L (interquartile range, 0.18-0.83). No correlation was observed with plasma concentrations of p,p'-dichlorodiphenyl dichloroethene (ρ = 0.017) or polychlorinated biphenyl 153 (ρ = -0.016), the other main organochlorine compounds detected. A 1-log10 increase in chlordecone concentration was associated with a decreased length of gestation (-0.27 weeks; 95% confidence interval: -0.50, -0.03) and an increased risk of preterm birth (60%; 95% confidence interval: 10, 130). These associations may result from the estrogen-like and progestin-like properties of chlordecone. These results are of public health relevance because of the prolonged persistence of chlordecone in the environment and the high background rate of preterm births in this population.
持久性有机污染物与妊娠时间或早产均无明确关联。氯丹是一种有机氯农药，曾广泛用于控制法属西印度群岛的香蕉根蛀虫。使用 2004 年至 2007 年在瓜德罗普岛开展的 Timoun 母婴队列研究的数据，来检测母体血浆中氯丹浓度与 818 名孕妇妊娠时间及早产率之间的关系。采用多元线性回归分析妊娠时间，采用 Cox 模型分析早产率。血浆中氯丹的中位数浓度为 0.39µg/L（四分位间距，0.18-0.83）。氯丹与血浆中 p,p'-二氯二苯二氯乙烯（ρ=0.017）或多氯联苯 153（ρ=-0.016）（其他主要有机氯化合物）的浓度均无相关性。氯丹浓度每增加 1 个对数值，妊娠时间就会减少 0.27 周（95%置信区间：-0.50，-0.03），早产风险增加 60%（95%置信区间：10，130）。这些关联可能是由于氯丹具有类雌激素和类孕激素特性所致。这些结果具有公共卫生相关性，因为氯丹在环境中具有长期持久性，并且该人群的早产率本来就很高。
