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孕期母体高氯酸盐暴露与出生结局改变

Maternal perchlorate exposure in pregnancy and altered birth outcomes.

作者信息

Rubin Rainbow, Pearl Michelle, Kharrazi Martin, Blount Benjamin C, Miller Mark D, Pearce Elizabeth N, Valentin-Blasini Liza, DeLorenze Gerald, Liaw Jane, Hoofnagle Andrew N, Steinmaus Craig

机构信息

School of Public Health, University of California, Berkeley, CA, USA.

Sequoia Foundation, La Jolla, CA, USA.

出版信息

Environ Res. 2017 Oct;158:72-81. doi: 10.1016/j.envres.2017.05.030. Epub 2017 Jun 9.

Abstract

BACKGROUND

At high medicinal doses perchlorate is known to decrease the production of thyroid hormone, a critical factor for fetal development. In a large and uniquely exposed cohort of pregnant women, we recently identified associations between environmental perchlorate exposures and decreased maternal thyroid hormone during pregnancy. Here, we investigate whether perchlorate might be associated with birthweight or preterm birth in the offspring of these women.

METHODS

Maternal urinary perchlorate, serum thyroid hormone concentrations, birthweight, gestational age, and urinary nitrate, thiocyanate, and iodide were collected in 1957 mother-infant pairs from San Diego County during 2000-2003, a period when the county's water supply was contaminated with perchlorate. Associations between perchlorate exposure and birth outcomes were examined using linear and logistic regression analyses adjusted for maternal age, weight, race/ethnicity, and other factors.

RESULTS

Perchlorate was not associated with birth outcomes in the overall population. However, in analyses confined to male infants, log maternal perchlorate concentrations were associated with increasing birthweight (β=143.1gm, p=0.01), especially among preterm births (β=829.1g, p<0.001). Perchlorate was associated with male preterm births ≥2500g (odds ratio=3.03, 95% confidence interval=1.09-8.40, p-trend=0.03). Similar associations were not seen in females.

CONCLUSIONS

This is the first study to identify associations between perchlorate and increasing birthweight. Further research is needed to explore the differences we identified related to infant sex, preterm birth, and other factors. Given that perchlorate exposure is ubiquitous, and that long-term impacts can follow altered birth outcomes, future research on perchlorate could have widespread public health importance.

摘要

背景

已知高剂量的高氯酸盐会降低甲状腺激素的生成,而甲状腺激素是胎儿发育的关键因素。在一个规模庞大且暴露情况独特的孕妇队列中,我们最近发现环境中高氯酸盐暴露与孕期母体甲状腺激素水平降低之间存在关联。在此,我们调查高氯酸盐是否可能与这些女性后代的出生体重或早产有关。

方法

在2000年至2003年期间,从圣地亚哥县收集了1957对母婴的母体尿高氯酸盐、血清甲状腺激素浓度、出生体重、孕周以及尿硝酸盐、硫氰酸盐和碘化物。使用线性回归和逻辑回归分析来检验高氯酸盐暴露与出生结局之间的关联,并对母体年龄、体重、种族/族裔和其他因素进行了调整。

结果

在总体人群中,高氯酸盐与出生结局无关。然而,在仅限于男婴的分析中,母体高氯酸盐浓度的对数值与出生体重增加相关(β=143.1克,p=0.01),尤其是在早产婴儿中(β=829.1克,p<0.001)。高氯酸盐与出生体重≥2500克的男性早产有关(优势比=3.03,95%置信区间=1.09-8.40,p趋势=0.03)。在女性中未观察到类似的关联。

结论

这是第一项确定高氯酸盐与出生体重增加之间存在关联的研究。需要进一步研究来探索我们所发现的与婴儿性别、早产和其他因素相关的差异。鉴于高氯酸盐暴露普遍存在,且出生结局改变可能会产生长期影响,未来关于高氯酸盐的研究可能具有广泛的公共卫生重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d288/5578729/8da42ebf39e0/nihms883482f3.jpg

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