Institute of Population Research/China Center on Population Health and Development, Peking University, No. 5 Yiheyuan Road, Haidian District, Beijing,100871, China.
Department of Andrology, Jinling Hospital, School of Medicine, Nanjing University, No. 305, East Zhongshan Road, Nanjing, 210002, China.
Int Health. 2023 May 2;15(3):299-308. doi: 10.1093/inthealth/ihac027.
Maternal exposure to pesticides during early pregnancy is associated with increased risks of birth defects, while the association between maternal exposure to chemical fertilizer during pregnancy and the risk of birth defects remains unknown.
Data were from a population-based birth defects surveillance system between 2007 and 2012 in Pingding County, Shanxi Province, northern China. A total of 14 074 births with 235 birth defects were used to estimate spatial clustering and correlations at the village level. A population-based case-control study of 157 cases with birth defects and 204 controls was performed to investigate the association between maternal chemical fertilizer exposure and the risk of birth defects by a two-level logistic model.
The total prevalence of birth defects between 2007 and 2012 was 167.0/10 000 births. The spatial analysis indicated a remarkable high-risk area of birth defects in the southeast of Pingding County and the use of chemical fertilizer was associated with the risk of birth defects at the village level. After adjusting for confounders at the individual level, mothers who live in villages with chemical fertilizer application ≥65 tons/y had an increased risk of birth defects (adjusted odds ratio 2.06 [95% confidence interval 1.23 to 3.46]) compared with those of <65 tons/y.
Our findings suggest that the risk of birth defects may be associated with the use of chemical fertilizer in rural northern China. The findings must be cautiously interpreted and need to be investigated on larger samples.
母亲在妊娠早期接触农药与出生缺陷风险增加有关，而妊娠期间接触化肥与出生缺陷风险之间的关系尚不清楚。
数据来自中国北方山西省平定县 2007 年至 2012 年的基于人群的出生缺陷监测系统。共有 14074 例出生和 235 例出生缺陷用于估计村级水平的空间聚类和相关性。采用基于人群的病例对照研究，对 157 例出生缺陷病例和 204 例对照进行研究，通过两级逻辑模型调查母体化肥暴露与出生缺陷风险之间的关系。
2007 年至 2012 年总出生缺陷患病率为 167.0/10000 活产。空间分析表明，平定县东南部存在出生缺陷的高风险地区，且化肥的使用与村级出生缺陷风险相关。在个体水平调整混杂因素后，与使用化肥<65 吨/年的母亲相比，居住在使用化肥≥65 吨/年的村庄的母亲出生缺陷的风险增加（调整后的比值比为 2.06 [95%置信区间为 1.23 至 3.46]）。
我们的研究结果表明，出生缺陷的风险可能与中国北方农村使用化肥有关。这些发现必须谨慎解释，并需要在更大的样本中进行研究。
