Bloom Michael S, Buck Louis Germaine M, Sundaram Rajeshwari, Maisog Jose M, Steuerwald Amy J, Parsons Patrick J
Department of Environmental Health Sciences, University at Albany School of Public Health, State University of New York, Rensselaer, NY, USA; Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, NY, USA.
Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.
Environ Res. 2015 Apr;138:118-29. doi: 10.1016/j.envres.2015.01.008. Epub 2015 Feb 20.
Evidence suggests that trace exposures to select elements may increase the risk for adverse birth outcomes. To investigate further, we used multiple regression to assess associations between preconception parental exposures to Pb, Cd, and total Hg in blood, and 21 elements in urine, with n=235 singleton birth outcomes, adjusted for confounders and partner's exposure. Earlier gestational age at delivery (GA) was associated with higher tertiles of urine maternal W (-1.22 days) and paternal U (-1.07 days), but GA was later for higher tertiles of maternal (+1.11 days) and paternal (+1.30 days) blood Hg. Additional analysis indicated shorter GA associated with higher paternal urine Ba, W, and U, and with higher maternal blood Pb for boys, but GA was longer in association with higher maternal urine Cr. Birth weight (BW) was lower for higher tertiles of paternal urine Cs (-237.85g), U (-187.34g), and Zn (-209.08g), and for higher continuous Cr (P=0.021). In contrast, BW was higher for higher tertiles of paternal urine As (+194.71g) and counterintuitively for maternal blood Cd (+178.52g). Birth length (BL) was shorter for higher tertiles of urine maternal W (-1.22cm) and paternal U (-1.10cm). Yet, higher tertiles of maternal (+1.11cm) and paternal (+1.30) blood Hg were associated with longer BL. Head circumference at delivery was lower for higher tertiles of paternal urine U (-0.83cm), and for higher continuous Mo in boys (-0.57cm). Overall, associations were most consistently indicated for GA and measures of birth size with urine W and U, and paternal exposures were more frequently associated than maternal. Though limited by several factors, ours is the largest multi-element investigation of prospective couple-level trace exposures and birth outcomes to date; the novel observations for W and U merit further investigation.
有证据表明，微量接触特定元素可能会增加不良出生结局的风险。为了进一步研究，我们使用多元回归来评估孕前父母血液中铅（Pb）、镉（Cd）和总汞（Hg）以及尿液中21种元素的暴露与235例单胎出生结局之间的关联，并对混杂因素和伴侣的暴露情况进行了调整。分娩时孕周较小与母亲尿液中钨（W）和父亲尿液中铀（U）处于较高三分位数有关（分别为 -1.22天和 -1.07天），但母亲血液汞（+1.11天）和父亲血液汞（+1.30天）处于较高三分位数时孕周较晚。进一步分析表明，男孩的孕周较短与父亲尿液中钡（Ba）、钨和铀含量较高以及母亲血液铅含量较高有关，但孕周较长与母亲尿液中铬（Cr）含量较高有关。父亲尿液中铯（Cs）（-237.85克）、铀（-187.34克）和锌（Zn）（-209.08克）处于较高三分位数以及连续铬含量较高时（P = 0.021），出生体重（BW）较低。相比之下，父亲尿液中砷（As）处于较高三分位数时出生体重较高（+194.71克），而母亲血液镉处于较高三分位数时出生体重较高（+178.52克），这与直觉相反。母亲尿液中钨（-1.22厘米）和父亲尿液中铀（-1.10厘米）处于较高三分位数时出生身长（BL）较短。然而，母亲血液汞（+1.11厘米）和父亲血液汞（+1.30厘米）处于较高三分位数时与出生身长较长有关。分娩时头围较小与父亲尿液中铀处于较高三分位数以及男孩连续钼含量较高有关（-0.57厘米）。总体而言，孕周以及出生大小指标与尿液中钨和铀的关联最为一致，而且父亲的暴露比母亲的暴露更常与之相关。尽管受到几个因素的限制，但我们的研究是迄今为止对前瞻性夫妇层面微量暴露与出生结局进行的最大规模的多元素调查；关于钨和铀的新观察结果值得进一步研究。
