Cheng Lu, Zhang Bin, Zheng Tongzhang, Hu Jie, Zhou Aifen, Bassig Bryan A, Xia Wei, Savitz David A, Buka Stephen, Xiong Chao, Braun Joseph M, Zhang Yaqi, Zhou Yanqiu, Pan Xinyun, Wu Chuansha, Wang Youjie, Qian Zhengmin, Yang Aimin, Romano Megan E, Shi Kunchong, Xu Shunqing, Li Yuanyuan
Key Laboratory of Environment and Health (HUST), Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, China.
Int J Environ Res Public Health. 2017 Jan 9;14(1):58. doi: 10.3390/ijerph14010058.
Prenatal cadmium (Cd) exposure has been associated with adverse birth outcomes, but the findings of previous studies are inconsistent. We measured Cd concentrations in urine samples at or near 13, 24, and 35 gestational weeks from 282 women in Wuhan, China. We used generalized estimating equation models to assess the associations between maternal creatinine adjusted urinary Cd concentrations at each trimester and birth size. A significant inverse association was observed between higher maternal Cd levels measured during the 1st trimester and birth size in girls. For each log unit increase in Cd (µg/g creatinine) levels from the 1st trimester, there was a decrease in birth weight by 116.99 g (95% confidence interval (CI): -208.87, -25.11 g). The Cd levels from the 1st and 2nd trimesters were also borderline significantly associated with ponderal index in girls. Joint estimation of trimester-specific effects suggested that associations with Cd levels for ponderal index ( = 0.02) were significantly different across trimesters, and differences for effects across trimesters for birth weight were marginally significant ( = 0.08) in girls. No significant associations were observed between Cd levels from any trimester and birth size in boys. Maternal Cd exposure during earlier periods of pregnancy may have a larger impact on delayed fetal growth.
产前镉（Cd）暴露与不良出生结局有关，但先前研究的结果并不一致。我们测量了来自中国武汉的282名女性在妊娠13周、24周和35周及前后的尿液样本中的镉浓度。我们使用广义估计方程模型来评估各孕期母亲肌酐校正后的尿镉浓度与出生体重之间的关联。在孕早期测量的较高母亲镉水平与女孩出生体重之间观察到显著的负相关。孕早期镉（μg/g肌酐）水平每增加一个对数单位，出生体重就会降低116.99克（95%置信区间（CI）：-208.87，-25.11克）。孕早期和孕中期的镉水平也与女孩的 ponderal 指数存在临界显著关联。对各孕期特定效应的联合估计表明，女孩中 ponderal 指数与镉水平的关联（P = 0.02）在各孕期之间存在显著差异，各孕期对出生体重影响的差异在女孩中边缘显著（P = 0.08）。在任何孕期的镉水平与男孩出生体重之间均未观察到显著关联。孕期早期母亲的镉暴露可能对胎儿生长迟缓有更大影响。
