CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France; Department of Obstetrics and Gynecology and Reproductive Medicine, Anne de Bretagne University Hospital, Rennes, France.
Univ Rennes, Inserm, EHESP, Irset - UMR_S 1085, F-35000, Rennes, France.
Environ Res. 2021 Jun;197:111048. doi: 10.1016/j.envres.2021.111048. Epub 2021 Mar 22.
Preeclampsia is a pregnancy-specific syndrome caused by abnormal placentation. Although environmental chemicals, including some pesticides, are suspected of impairing placentation and promoting preeclampsia, its relationship with preeclampsia has been insufficiently explored.
We aimed to investigate the relation between non-occupational exposure to pesticides during pregnancy and the risk of preeclampsia.
The study cohort comprised 195 women with and 17,181 without preeclampsia from the ELFE birth cohort. We used toxicogenomic approaches to select 41 pesticides of interest for their possible influence on preeclampsia. We assessed household pesticide use (self-reported data), environmental exposure to agricultural pesticides (geographic information systems), and dietary exposure (food-frequency questionnaire with data from monitoring pesticide residues in food and water). Dietary exposures to pesticides were grouped into clusters of similar exposures to resolve collinearity issues. For each exposure source, pesticides were mutually adjusted, and odds ratios estimated with logistic regression models.
The quantity of prochloraz applied within a kilometer of the women's homes was higher in women with than without preeclampsia (fourth quartile vs. others; adjusted odds ratio [aOR] = 1.54; 95%CI: 1.02, 2.35), especially when preeclampsia was diagnosed before 34 weeks of gestation (aOR = 2.25; 95%CI: 1.01, 5.06). The reverse was observed with nearby cypermethrin application (aOR = 0.59, 95%CI: 0.36, 0.96). In sensitivity analyses, women with preeclampsia receiving antihypertensive treatment had a significantly higher probability of using herbicides at home during pregnancy than women without preeclampsia (aOR = 2.20; 95%CI: 1.23, 3.93). No statistically significant association was found between dietary exposure to pesticide residues and preeclampsia.
While the most of the associations examined remained statistically non-significant, our results suggest the possible influence on preeclampsia of residential exposures to prochloraz and some herbicides. These estimations are supported by toxicological and mechanistic data.
子痫前期是一种由胎盘异常引起的妊娠特有的综合征。虽然环境化学物质，包括一些农药，被怀疑会损害胎盘并促进子痫前期的发生，但它们与子痫前期的关系尚未得到充分探讨。
本研究旨在探讨妊娠期间非职业性暴露于农药与子痫前期风险之间的关系。
本研究队列包括来自 ELFE 出生队列的 195 名子痫前期患者和 17181 名非子痫前期患者。我们采用毒理学方法选择了 41 种可能影响子痫前期的农药。我们评估了家庭农药使用情况（自我报告数据）、农业农药环境暴露情况（地理信息系统）和饮食暴露情况（食物频率问卷，数据来源于监测食物和水中的农药残留）。将饮食暴露于农药的情况分为类似暴露的聚类，以解决共线性问题。对于每个暴露源，相互调整了农药，并使用逻辑回归模型估计了比值比。
与无子痫前期患者相比，家中周围一公里内施用的百菌清量更高（第四四分位数与其他四分位数相比；调整后的比值比[aOR] = 1.54；95%CI：1.02，2.35），尤其是在子痫前期在 34 周前诊断时（aOR = 2.25；95%CI：1.01，5.06）。相反，周围施用氯菊酯时，其比值降低（aOR = 0.59，95%CI：0.36，0.96）。在敏感性分析中，子痫前期患者接受降压治疗者，在妊娠期间家中使用除草剂的可能性明显高于无子痫前期患者（aOR = 2.20；95%CI：1.23，3.93）。饮食暴露于农药残留与子痫前期之间未发现具有统计学意义的关联。
虽然大多数检查到的关联在统计学上仍无显著性，但我们的结果表明，住宅暴露于百菌清和某些除草剂可能对子痫前期有影响。这些估计得到了毒理学和机制数据的支持。
