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孕期环境暴露:对产前发育和生命早期的影响:全面综述。

Environmental Exposure during Pregnancy: Influence on Prenatal Development and Early Life: A Comprehensive Review.

机构信息

BCNatal, Barcelona Centre for Maternal Foetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.

Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain.

出版信息

Fetal Diagn Ther. 2021;48(4):245-257. doi: 10.1159/000514884. Epub 2021 Mar 18.

Abstract

Preconception and prenatal exposure to environmental contaminants may affect future health. Pregnancy and early life are critical sensitive windows of susceptibility. The aim of this review was to summarize current evidence on the toxic effects of environment exposure during pregnancy, the neonatal period, and childhood. Alcohol use is related to foetal alcohol spectrum disorders, foetal alcohol syndrome being its most extreme form. Smoking is associated with placental abnormalities, preterm birth, stillbirth, or impaired growth and development, as well as with intellectual impairment, obesity, and cardiovascular diseases later in life. Negative birth outcomes have been linked to the use of drugs of abuse. Pregnant and lactating women are exposed to endocrine-disrupting chemicals and heavy metals present in foodstuffs, which may alter hormones in the body. Prenatal exposure to these compounds has been associated with pre-eclampsia and intrauterine growth restriction, preterm birth, and thyroid function. Metals can accumulate in the placenta, causing foetal growth restriction. Evidence on the effects of air pollutants on pregnancy is constantly growing, for example, preterm birth, foetal growth restriction, increased uterine vascular resistance, impaired placental vascularization, increased gestational diabetes, and reduced telomere length. The advantages of breastfeeding outweigh any risks from contaminants. However, it is important to assess health outcomes of toxic exposures via breastfeeding. Initial studies suggest an association between pre-eclampsia and environmental noise, particularly with early-onset pre-eclampsia. There is rising evidence of the negative effects of environmental contaminants following exposure during pregnancy and breastfeeding, which should be considered a major public health issue.

摘要

孕前和产前接触环境污染物可能会影响未来的健康。怀孕和生命早期是易感性的关键敏感窗口。本综述的目的是总结目前关于怀孕期间、新生儿期和儿童期环境暴露的毒性作用的证据。饮酒与胎儿酒精谱系障碍有关,而胎儿酒精综合征是其最极端的形式。吸烟与胎盘异常、早产、死产或生长发育受损以及智力障碍、肥胖和心血管疾病有关。滥用药物与不良的出生结局有关。孕妇和哺乳期妇女接触到食物中存在的内分泌干扰化学物质和重金属,这些物质可能会改变体内的激素。这些化合物的产前暴露与子痫前期和宫内生长受限、早产以及甲状腺功能有关。金属可以在胎盘内积累,导致胎儿生长受限。关于空气污染对妊娠影响的证据不断增加,例如早产、胎儿生长受限、子宫血管阻力增加、胎盘血管化受损、妊娠糖尿病增加和端粒缩短。母乳喂养的好处超过了污染物的任何风险。然而,通过母乳喂养评估有毒暴露的健康结果非常重要。初步研究表明,子痫前期与环境噪声之间存在关联,特别是与早发型子痫前期之间存在关联。越来越多的证据表明,妊娠和哺乳期接触环境污染物会产生负面影响,这应被视为一个主要的公共卫生问题。

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