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中国武汉妊娠晚期饮用水消毒副产物暴露的尿生物标志物与胎儿生长的超声测量

Urinary biomarker of late pregnancy exposure to drinking water disinfection by-products and ultrasound measures of fetal growth in Wuhan, China.

机构信息

Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.

Department of Thyroid and Breast Surgery, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.

出版信息

Environ Res. 2019 Mar;170:128-133. doi: 10.1016/j.envres.2018.12.018. Epub 2018 Dec 11.

Abstract

BACKGROUND

Disinfection by-products (DBPs) have been shown to be reproductive and developmental toxicity. However, few studies examine the effect of prenatal exposure to DBPs on fetal growth via ultrasound measures.

OBJECTIVE

To investigate the associations between maternal exposure to DBPs during late pregnancy and ultrasound measures of fetal growth.

METHODS

We included 332 pregnant women who presented to a hospital to wait for delivery in Wuhan, China. Ultrasound parameters of fetal growth including femur length (FL), head circumference (HC), abdominal circumference (AC) and biparietal diameter (BPD) were assessed. We measured maternal TCAA concentrations in first morning urine collected from late pregnancy as a biomarker of in utero DBP exposure levels. Multivariable linear regression models were used to examine the associations between maternal urinary TCAA concentrations during late pregnancy and ultrasound parameters of fetal growth.

RESULTS

We found that elevated maternal creatinine (Cr)-adjusted urinary TCAA levels had negative associations with BPD, HC and FL in boys but not in girls (P interaction = 0.04, 0.05 and 0.08, respectively). Male fetal BPD, HC and FL had decreases of 0.21 cm (95% CI: -0.35, -0.07; P for trend = 0.003), 0.46 cm (95% CI: -0.81, -0.10; P for trend = 0.01) and 0.17 cm (95% CI: -0.30, -0.04; P for trend = 0.01) for the highest vs. lowest tertile of Cr-adjusted urinary TCAA, respectively. These negative associations persisted for maternal Cr-adjusted urinary TCAA concentrations modeled as continuous variables.

CONCLUSION

The results from our study suggest that maternal exposure to TCAA during late pregnancy may have adverse effects on male fetal growth.

摘要

背景

消毒副产物(DBPs)已被证明具有生殖毒性和发育毒性。然而,很少有研究通过超声测量来检查妊娠晚期母体暴露于 DBPs 对胎儿生长的影响。

目的

探讨妊娠晚期母体暴露于 DBPs 与胎儿生长的超声测量值之间的关系。

方法

我们纳入了 332 名在中国武汉某医院等待分娩的孕妇。评估了胎儿生长的超声参数,包括股骨长(FL)、头围(HC)、腹围(AC)和双顶径(BPD)。我们测量了妊娠晚期首次晨尿中的母体 TCAA 浓度,作为宫内 DBPs 暴露水平的生物标志物。采用多变量线性回归模型,分析了妊娠晚期母体尿 TCAA 浓度与胎儿生长超声参数之间的关系。

结果

我们发现,校正母体肌酐(Cr)后的尿 TCAA 水平升高与男胎的 BPD、HC 和 FL 呈负相关,但与女胎无相关性(P 交互=0.04、0.05 和 0.08)。男胎的 BPD、HC 和 FL 分别下降了 0.21cm(95%CI:-0.35,-0.07;P 趋势=0.003)、0.46cm(95%CI:-0.81,-0.10;P 趋势=0.01)和 0.17cm(95%CI:-0.30,-0.04;P 趋势=0.01),最高 tertile 与最低 tertile 相比,校正 Cr 的尿 TCAA。当母体 Cr 校正后的尿 TCAA 浓度作为连续变量建模时,这些负相关仍然存在。

结论

本研究结果表明,妊娠晚期母体暴露于 TCAA 可能对男胎生长有不良影响。

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