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孕期邻苯二甲酸酯暴露的重复测量与孕妇血红蛋白浓度变化趋势:马鞍山出生队列(MABC)研究。

Repeated measures of prenatal phthalate exposure and maternal hemoglobin concentration trends: The Ma'anshan birth cohort (MABC) study.

机构信息

Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.

Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China.

出版信息

Environ Pollut. 2018 Nov;242(Pt B):1033-1041. doi: 10.1016/j.envpol.2018.07.132. Epub 2018 Aug 1.

Abstract

A prospective cohort study of a Chinese population was conducted to investigate the relationship between prenatal phthalates exposure and maternal hemoglobin or anemia. Based on the Ma'anshan Birth Cohort study, 7 phthalate metabolites were quantified in spot pregnancy urine samples (n = 9263) from 3269 pregnant women during each trimester. The maternal hemoglobin concentrations were obtained from electronic medical records at the same three time points for each participant during pregnancy. Anemia was defined as a hemoglobin concentration below 110 g/L in pregnant women. Repeated measures and trimester-specific analyses were used to estimate the effects of phthalates exposure on maternal hemoglobin and anemia. The prevalence of anemia was 3.6%, 27.0%, and 26.5% during the first, second and third trimester, respectively. Repeated measures analysis showed that hemoglobin concentrations decreased by 0.55, 0.19, 0.57, 0.49, and 0.54 g/L with each 1 ln-transformed concentration increase of MBP, MBzP, MEHP, MEOHP, and MEHHP, respectively. Exposure to MMP, MBP, MEHP, MEOHP, and MEHHP increased the risk of anemia by 1.11-fold, 1.21-fold, 1.20-fold, 1.13-fold, and 1.16-fold, respectively. Trimester-specific regression models stratified by the sample collection time during pregnancy generated consistent results. This is the first study focusing on the effect of prenatal phthalate exposures on hemoglobin or anemia in pregnant Chinese women. We found that prenatal phthalates exposure not only decreased the concentrations of hemoglobin but also showed associations with the prevalence of anemia. Associations appeared stronger for the subsample representing women pregnant with a male fetus than those pregnant with a female fetus. Anemia remains a moderate public health problem in China, and effective measures should be implemented.

摘要

一项针对中国人群的前瞻性队列研究旨在探讨产前邻苯二甲酸酯暴露与孕妇血红蛋白或贫血之间的关系。基于马鞍山出生队列研究,在每个孕期的三个时间点,从 3269 名孕妇的妊娠尿液样本中定量检测了 7 种邻苯二甲酸酯代谢物(n=9263)。在妊娠期间的每个参与者在同一三个时间点从电子病历中获得了母亲的血红蛋白浓度。贫血定义为孕妇血红蛋白浓度低于 110g/L。重复测量和特定于妊娠三个时期的分析用于估计邻苯二甲酸酯暴露对孕妇血红蛋白和贫血的影响。在妊娠第一、第二和第三孕期,贫血的患病率分别为 3.6%、27.0%和 26.5%。重复测量分析表明,随着 1ln 转化浓度每增加 1 个单位,血红蛋白浓度分别下降 0.55、0.19、0.57、0.49 和 0.54g/L。暴露于 MMP、MBP、MEHP、MEOHP 和 MEHHP 会使贫血的风险分别增加 1.11 倍、1.21 倍、1.20 倍、1.13 倍和 1.16 倍。根据妊娠期间样本采集时间分层的特定于妊娠三个时期的回归模型产生了一致的结果。这是第一项专注于产前邻苯二甲酸酯暴露对中国孕妇血红蛋白或贫血影响的研究。我们发现,产前邻苯二甲酸酯暴露不仅降低了血红蛋白浓度,而且与贫血的患病率有关。对于代表怀有男性胎儿的女性亚样本的关联比代表怀有女性胎儿的女性亚样本的关联更强。贫血在中国仍然是一个中等程度的公共卫生问题,应采取有效措施。

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