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妊娠期间母体金属浓度与儿童发病:探索性分析。

Maternal metal concentration during gestation and pediatric morbidity in children: an exploratory analysis.

机构信息

Environmental Epidemiology, Ministry of Health, Jerusalem, Israel.

Neonatology Department, Soroka University Medical Center, Beer-Sheva, Israel.

出版信息

Environ Health Prev Med. 2021 Mar 25;26(1):40. doi: 10.1186/s12199-021-00963-z.

Abstract

BACKGROUND

The majority of studies linking exposure to metals with certain health outcomes focus on known toxic metals. Alternatively, this study assesses the extent to which exposure to a wider range of metals during gestation is associated with childhood morbidity.

METHODS

We analyzed the concentrations of 25 metals found in urine samples of 111 pregnant women of Arab-Bedouin origin collected prior to birth. In addition, we collected medical records on their offspring for six years following birth, including every interaction with HMOs, local hospitals, and pharmacies.

RESULTS

The main types of morbidities diagnosed and treated during this period were preterm births, malformations, asthma-like morbidity, cardiovascular and behavioral problems, and obesity. Multivariable analysis showed that offspring born before term were more likely to have been exposed to elevated maternal concentrations of zinc, thallium, aluminum, manganese, and uranium, all with adjusted relative risk above 1.40 for an increase by each quintile. Likewise, children with asthma had been exposed to higher levels of magnesium, strontium, and barium at gestation, while behavioral outcomes were associated with elevated biometals, i.e., sodium, magnesium, calcium, selenium, and zinc, as well as higher levels of lithium, cobalt, nickel, strontium, cadmium, vanadium, arsenic, and molybdenum. A heatmap of adjusted relative risk estimates indicates the considerable implications that exposure to metals may have for preterm birth and developmental outcomes.

CONCLUSIONS

The current study shows that perinatal exposure to metals is adversely associated with pediatric morbidity. Further such analyses on additional samples are warranted.

摘要

背景

大多数将金属暴露与某些健康结果联系起来的研究都集中在已知的有毒金属上。相比之下,本研究评估了在妊娠期间接触更广泛的金属范围与儿童发病率之间的关联程度。

方法

我们分析了 111 名阿拉伯-贝都因血统孕妇在出生前采集的尿液样本中发现的 25 种金属的浓度。此外,我们还收集了她们的后代在出生后六年的医疗记录,包括与 HMO、当地医院和药店的每一次互动。

结果

在此期间诊断和治疗的主要疾病类型是早产、畸形、哮喘样发病、心血管和行为问题以及肥胖。多变量分析表明,足月前出生的后代更有可能接触到母亲体内锌、铊、铝、锰和铀的浓度升高,所有这些金属的调整相对风险均高于 1.40,即每个五分位数的增加。同样,患有哮喘的儿童在妊娠期间接触到了更高水平的镁、锶和钡,而行为结果与生物金属(即钠、镁、钙、硒和锌)以及更高水平的锂、钴、镍、锶、镉、钒、砷和钼的水平升高有关。调整相对风险估计值的热图表明,金属暴露可能对早产和发育结果产生相当大的影响。

结论

本研究表明,围产期暴露于金属与儿科发病率呈负相关。有必要对其他样本进行进一步的此类分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cffc/7995788/8eeef061b4a5/12199_2021_963_Fig1_HTML.jpg

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