Shaw Gary M, Yang Wei, Roberts Eric, Kegley Susan E, Padula Amy, English Paul B, Carmichael Suzan L
Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, California.
Birth Defects Res A Clin Mol Teratol. 2014 Sep;100(9):686-94. doi: 10.1002/bdra.23263. Epub 2014 Jun 7.
Prevalence of gastroschisis has inexplicably been increasing over the past few decades. Our intent was to explore whether early gestational exposures to pesticides were associated with risk of gastroschisis.
We used population-based data, accompanied by detailed information from maternal interviews as well as information on residential proximity to a large number of commercial pesticide applications during early pregnancy. The study population derived from the San Joaquin Valley of California (). Cases were 156 infants/fetuses with gastroschisis and controls were 785 infants without birth defects.
Among 22 chemical pesticide groups analyzed, none had an elevated odds ratio with an associated confidence interval that excluded 1.0, although exposure to the triazine group showed borderline significance. Among 36 specific pesticide chemicals analyzed, only exposure to petroleum distillates was associated with an elevated risk, odds ratio = 2.5 (1.1-5.6). In general, a substantially different inference was not derived when analyses were stratified by maternal age or when risk estimation included adjustment for race/ethnicity, body mass index, folic acid supplement use, and smoking.
Our study rigorously adds to the scant literature on this topic. Our a priori expectation was that we would observe certain pesticide compounds to be particularly associated with young age owing to the disproportionate risk observed for young women to have offspring with gastroschisis. We did not observe an exposure profile unique to young women.
在过去几十年中,腹裂的患病率一直在莫名其妙地上升。我们的目的是探讨妊娠早期接触农药是否与腹裂风险相关。
我们使用了基于人群的数据,并辅以产妇访谈的详细信息以及关于孕早期居住地点与大量商业农药施用地点距离的信息。研究人群来自加利福尼亚州的圣华金谷()。病例为156例患有腹裂的婴儿/胎儿,对照为785例无出生缺陷的婴儿。
在分析的22种化学农药组中,没有一种的优势比升高且相关置信区间排除1.0,尽管三嗪组的暴露显示出临界显著性。在分析的36种特定农药化学品中,只有接触石油馏出物与风险升高相关,优势比 = 2.5(1.1 - 5.6)。一般来说,按产妇年龄分层进行分析或在风险估计中纳入种族/族裔、体重指数、叶酸补充剂使用情况和吸烟情况进行调整时,并未得出实质性不同的推断。
我们的研究严格地补充了关于这个主题的稀少文献。我们预先的期望是,由于年轻女性生育患有腹裂后代的风险不成比例,我们会观察到某些农药化合物与年轻年龄特别相关。我们没有观察到年轻女性特有的暴露情况。