Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China.
Eur J Public Health. 2017 Dec 1;27(6):1102-1107. doi: 10.1093/eurpub/ckx148.
Although recent studies have indicated the potential adverse effects of maternal bisphenol A (BPA) exposure on pregnancy such as increasing the risk of pre-eclampsia, epidemiological evidence is limited. We aimed to evaluate the relationship between maternal BPA exposure and the risk of pre-eclampsia.
We conducted a nested case-control study among 173 women (74 cases of pre-eclampsia and 99 controls). BPA concentrations were measured using liquid chromatography-mass spectrometry in the maternal serum samples collected during 16-20 gestational weeks. Multivariate logistic models were used to examine the relationship between maternal serum BPA concentrations and the risk of pre-eclampsia.
BPA was detectable (>0.1 µg/l) in 78.6% of the maternal serum samples at three levels: low (<2.24 µg/l), medium (2.24-4.44 µg/l), and high (>4.44 µg/l). BPA concentrations were significantly higher in the serum samples collected from the pre-eclampsia cases than those from controls (median: 3.40 vs. 1.50 µg/l, P < 0.01). With adjustment for maternal age, primiparous and BMI, the odds of developing pre-eclampsia were significantly elevated in subjects with high serum BPA levels compared with those with low levels (adjusted OR = 16.46, 95%CI = 5.42-49.85) regardless of subcategories of pre-eclampsia including severity and onset time. Among the pre-eclampsia subjects, the maternal serum concentration of BPA was not different between the early- and late-onset subjects (median: 3.09 vs. 3.50 µg/l, P = 0.57), but surprisingly higher in mild pre-eclampsia subjects compared with severe pre-eclampsia subjects (median: 5.20 vs. 1.80 µg/l, P < 0.01).
These results demonstrated that maternal exposure to high level of BPA could be associated with an increased risk of pre-eclampsia.
尽管最近的研究表明，母体双酚 A（BPA）暴露对妊娠有潜在的不良影响，例如增加子痫前期的风险，但流行病学证据有限。我们旨在评估母体 BPA 暴露与子痫前期风险之间的关系。
我们在 173 名女性（74 例子痫前期病例和 99 例对照）中进行了一项嵌套病例对照研究。在妊娠 16-20 周期间采集的母体血清样本中，使用液相色谱-质谱法测定 BPA 浓度。使用多变量逻辑模型来检验母体血清 BPA 浓度与子痫前期风险之间的关系。
在 78.6%的母体血清样本中可检测到 BPA（>0.1μg/l），分为三个水平：低（<2.24μg/l）、中（2.24-4.44μg/l）和高（>4.44μg/l）。子痫前期病例的血清样本中 BPA 浓度明显高于对照组（中位数：3.40 vs. 1.50μg/l，P<0.01）。在调整了母体年龄、初产和 BMI 后，与低水平组相比，高水平组发生子痫前期的可能性显著增加（调整后的 OR=16.46，95%CI=5.42-49.85），无论子痫前期的严重程度和发病时间如何，都属于子类别。在子痫前期患者中，早发型和晚发型患者的母体血清 BPA 浓度无差异（中位数：3.09 vs. 3.50μg/l，P=0.57），但与严重子痫前期患者相比，轻度子痫前期患者的血清浓度明显更高（中位数：5.20 vs. 1.80μg/l，P<0.01）。
这些结果表明，母体暴露于高水平的 BPA 可能与子痫前期风险增加有关。
