Kuhnert B R, Kuhnert P M, Debanne S, Williams T G
Department of Obstetrics and Gynecology, Cleveland Metropolitan General Hospital, OH 44109.
Am J Obstet Gynecol. 1987 Nov;157(5):1247-51. doi: 10.1016/s0002-9378(87)80303-4.
It is universally accepted that smoking during pregnancy results in decreased infant birth weight. However, the mechanism for decreased birth weight is not completely understood. This study tested the hypothesis that the cadmium/zinc interaction in the maternal-fetal-placental unit of the mother who smokes could be related to birth weight. Thiocyanate was used as the index of smoking status and atomic absorption spectroscopy was used to determine trace elements. Results show that cord vein red blood cell zinc and maternal whole blood cadmium levels are significant predictors of infant birth weight when variance that is due to clinical factors and thiocyanate is controlled with stepwise multiple regression techniques (n = 202). Bivariate correlation techniques showed that the factors affecting birth weight were different in the smoking and nonsmoking groups. For example, in nonsmokers (n = 125), the cord vein red blood cell zinc level was positively related to birth weight. In smokers (n = 77), maternal whole blood cadmium, placental cadmium, and placental zinc levels were negatively related to birth weight; the ratio of placental zinc to placental cadmium and the cord vein red blood cell zinc level were positively related to birth weight. The results suggest that increased maternal cadmium and decreased cord vein red blood cell zinc levels in infants of smokers may be significant clinically since increased maternal whole blood cadmium and decreased cord vein red blood cell zinc levels are both significantly related to decreased birth weight.
普遍认为孕期吸烟会导致婴儿出生体重下降。然而，出生体重下降的机制尚未完全明确。本研究检验了这样一个假设：吸烟母亲的母胎 - 胎盘单位中镉/锌的相互作用可能与出生体重有关。硫氰酸盐被用作吸烟状况的指标，原子吸收光谱法用于测定微量元素。结果显示，当采用逐步多元回归技术控制由临床因素和硫氰酸盐引起的方差时（n = 202），脐静脉红细胞锌和母亲全血镉水平是婴儿出生体重的显著预测指标。双变量相关技术表明，吸烟组和非吸烟组中影响出生体重的因素有所不同。例如，在非吸烟者（n = 125）中，脐静脉红细胞锌水平与出生体重呈正相关。在吸烟者（n = 77）中，母亲全血镉、胎盘镉和胎盘锌水平与出生体重呈负相关；胎盘锌与胎盘镉的比值以及脐静脉红细胞锌水平与出生体重呈正相关。结果表明，吸烟者婴儿母亲体内镉含量增加以及婴儿脐静脉红细胞锌水平降低在临床上可能具有重要意义，因为母亲全血镉含量增加和脐静脉红细胞锌水平降低均与出生体重下降显著相关。
