孕期鄰苯二甲酸酯暴露水平及其對妊娠結(jié)局的影響
發(fā)布時間：2018-09-04 20:35
【摘要】：研究目的 PAEs作為一種全球范圍使用的塑料制品增塑劑,通過空氣、土壤、飲水、食物等多種環(huán)境介質(zhì)進入人體,危害身體健康。有研究表明孕婦PAEs暴露不僅可以引發(fā)孕期合并癥,而且對胎兒的生長發(fā)育及生殖系統(tǒng)造成潛在的影響。目前我國人群孕期PAEs暴露水平及其對妊娠結(jié)局影響的研究資料有限,本研究在評價孕期PAEs暴露水平的基礎(chǔ)上,初步探討了孕期PAEs暴露對胎兒生長發(fā)育及男性生殖系統(tǒng)的潛在影響,為預防出生前PAEs暴露的危害提供科學依據(jù)。 研究內(nèi)容和方法 1、孕期人群尿液中PAEs代謝產(chǎn)物含量測定：采集孕婦孕晚期尿液,運用固相萃取-三重四級桿高效液相色譜聯(lián)用質(zhì)譜法測定孕婦尿液中5種PAEs代謝產(chǎn)物水平。 2、孕期PAEs暴露與妊娠結(jié)局之間關(guān)聯(lián)性研究：建立母親-胎兒隊列,采用線性回歸模型分析母親尿液中5種PAEs代謝產(chǎn)物水平與胎兒生長發(fā)育指標(身長、體重)間的關(guān)系。1：2匹配病例對照研究中,運用條件logistic回歸模型分析母親PAEs暴露與早產(chǎn)的關(guān)系。 3、孕期PAEs暴露與男性胎兒性激素水平之間關(guān)聯(lián)性研究：采用線性模型進行孕期PAEs暴露與男性胎兒臍帶血中性激素水平關(guān)聯(lián)分析,探討孕期PAEs暴露對男性生殖系統(tǒng)發(fā)育的潛在影響。 研究結(jié)果 1、孕期人群尿液中5種PAEs代謝產(chǎn)物含量測定：232名孕婦孕晚期尿液中MMP、MEP、MBP、MBzP和MEHP中位數(shù)分別為49.51μg/L、13.19μg/L、7.22μg/L、0.30μg/L、30.03μg/L,經(jīng)肌酐調(diào)整后含量中位數(shù)分別為110.40μg/g、27.61μg/g、16.90μg/g、0,53μg/g、56.23μg/g。 2、孕期PAEs暴露與妊娠結(jié)局之間關(guān)聯(lián)性研究：211名胎兒生長發(fā)育與母親PAEs暴露的相關(guān)分析中,新生兒體重與母親尿液中MMP、MEP和∑PAEs含量呈負相關(guān)(r=-0.28,P0.05；r=-0.14,P0.05；r=-0.25,P0.001),新生兒身長與MEP水平呈負相關(guān)(r=-0.14,P=0.05);排除早產(chǎn)因素影響后,進一步分析孕期PAEs暴露與176名足月兒生長發(fā)育結(jié)局的關(guān)系,Pearson相關(guān)分析及多元線性回歸分析均未發(fā)現(xiàn)新生兒體重、身長與母親尿液中5種PAEs代謝產(chǎn)物含量間存在統(tǒng)計學關(guān)聯(lián)。單因素logistic回歸分析發(fā)現(xiàn)孕期DEHP暴露降低早產(chǎn)發(fā)生的風險OR=0.31(0.17～0.57)。經(jīng)協(xié)變量調(diào)整后,多因素logistic回歸分析結(jié)果顯示孕期DEHP暴露與早產(chǎn)間關(guān)系仍然存在統(tǒng)計學意義OR=0.23(0.08～0.64)。 3、孕期PAEs暴露與男性胎兒性激素水平之間關(guān)聯(lián)性研究：男性胎兒臍帶血中T、E2、P、FSH、LH、INSL3和SHBG含量均數(shù)分別為182.76ng/dl、5078.62pg/ml、779.18ng/ml、1.50IU/L、3.11IU/L、135.29pg/ml和98.78nmol/L。經(jīng)母親年齡、孕前BMI、孕次及分娩孕周調(diào)整后,多元線性回歸分析發(fā)現(xiàn)男性胎兒臍血清中E2含量與孕期BBzP暴露呈正相關(guān)(β=0.083,P=0.03)。T/E2與BBzP暴露呈負相關(guān)趨勢(β=-0.065,P=-0.07)。 研究結(jié)論 本研究中,5種PAEs代謝產(chǎn)物檢出率較高(63.8%～99.1%),說明天津地區(qū)孕婦普遍暴露于多種PAEs。孕期不同類型PAEs暴露均對胎兒生長發(fā)育和生殖系統(tǒng)造成危害,其中MMP和MEP可能影響新生兒體重、身長,母親DEHP暴露降低早產(chǎn)發(fā)生風險,孕期BBzP暴露影響男性新生兒性激素水平。
[Abstract]:research objective
PAEs, as a plasticizer used worldwide, enter the human body through air, soil, drinking water, food and other environmental media. Studies have shown that pregnant women exposed to PAEs can not only cause complications during pregnancy, but also have a potential impact on the growth and development of the fetus and reproductive system. In this study, the potential effects of prenatal exposure to PAEs on fetal growth and male reproductive system were preliminarily explored on the basis of evaluating the level of prenatal exposure to PAEs.
Research contents and methods
1. Determination of PAEs metabolites in the urine of pregnant women during pregnancy: The urine of pregnant women in late pregnancy was collected, and the levels of 5 kinds of PAEs metabolites in the urine of pregnant women were determined by solid phase extraction-triple four-stage high performance liquid chromatography-mass spectrometry.
2. Correlation between maternal and fetal PAEs exposure during pregnancy: A maternal-fetal cohort was established, and the relationship between maternal urinary 5 kinds of PAEs metabolites and fetal growth and development indicators (length, weight) was analyzed by linear regression model. In a 1:2 matched case-control study, conditional logistic regression model was used to analyze maternal PAEs exposure and fetal outcomes. The relationship between preterm delivery.
3. Study on the relationship between pregnant PAEs exposure and male fetal sex hormone level: Linear model was used to analyze the relationship between pregnant PAEs exposure and male fetal umbilical cord blood sex hormone level, and to explore the potential impact of pregnant PAEs exposure on male reproductive system development.
Research results
1. Determination of 5 kinds of PAEs metabolites in urine of pregnant women: Medians of MMP, MEP, MBzP, MEHP in urine of 232 pregnant women in the third trimester of pregnancy were 49.51 ug/L, 13.19 ug/L, 7.22 ug/L, 0.30 ug/L, 30.03 ug/L, and 110.40 ug/g, 27.61 ug/g, 16.90 ug/g, 0, 53 ug/g, 56.23 ug/g, respectively.
2. Correlation between PAEs exposure during pregnancy and pregnancy outcomes: In the correlation analysis between fetal growth and maternal PAEs exposure, neonatal weight was negatively correlated with maternal urinary MMP, MEP and_PAEs (r =-0.28, P 0.05; R =-0.14, P 0.05; P 0.05; R =-0.25, P 0.001), and neonatal length was negatively correlated with MEP level (r =-0.14, P = 0.05). After preterm delivery, the relationship between PAEs exposure during pregnancy and the growth and development outcomes of 176 full-term infants was further analyzed. Pearson correlation analysis and multiple linear regression analysis showed no neonatal weight. There was a statistical correlation between body length and the contents of five PAEs metabolites in mother's urine. The risk of premature delivery was reduced by OR = 0.31 (0.17-0.57). Multivariate logistic regression analysis showed that the relationship between DEHP exposure during pregnancy and premature delivery was still statistically significant OR = 0.23 (0.08-0.64).
3. Correlation between maternal exposure to PAEs and male fetal sex hormone levels: The mean levels of T, E2, P, FSH, LH, INSL 3 and SHBG in umbilical cord blood of male fetuses were 182.76ng/dl, 5078.62 pg/ml, 779.18 ng/ml, 1.50 IU/L, 3.11 IU/L, 135.29 pg/ml and 98.78 nmol/L, respectively. The results showed that the level of E2 in umbilical cord serum of male fetus was positively correlated with BBzP exposure during pregnancy (beta = 0.083, P = 0.03). T/E2 was negatively correlated with BBzP exposure (beta = - 0.065, P = - 0.07).
research conclusion
In this study, the detection rate of 5 kinds of PAEs metabolites was high (63.8% ~ 99.1%), indicating that pregnant women in Tianjin were generally exposed to a variety of PAEs. Different types of PAEs during pregnancy were harmful to fetal growth and reproductive system. MMP and MEP may affect neonatal weight, body length, maternal DEHP exposure reduced the risk of premature delivery, and BBzP outbreak during pregnancy. Exposure affects the level of sex hormones in male newborns.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R114
本文編號：2223258
[Abstract]:research objective
PAEs, as a plasticizer used worldwide, enter the human body through air, soil, drinking water, food and other environmental media. Studies have shown that pregnant women exposed to PAEs can not only cause complications during pregnancy, but also have a potential impact on the growth and development of the fetus and reproductive system. In this study, the potential effects of prenatal exposure to PAEs on fetal growth and male reproductive system were preliminarily explored on the basis of evaluating the level of prenatal exposure to PAEs.
Research contents and methods
1. Determination of PAEs metabolites in the urine of pregnant women during pregnancy: The urine of pregnant women in late pregnancy was collected, and the levels of 5 kinds of PAEs metabolites in the urine of pregnant women were determined by solid phase extraction-triple four-stage high performance liquid chromatography-mass spectrometry.
2. Correlation between maternal and fetal PAEs exposure during pregnancy: A maternal-fetal cohort was established, and the relationship between maternal urinary 5 kinds of PAEs metabolites and fetal growth and development indicators (length, weight) was analyzed by linear regression model. In a 1:2 matched case-control study, conditional logistic regression model was used to analyze maternal PAEs exposure and fetal outcomes. The relationship between preterm delivery.
3. Study on the relationship between pregnant PAEs exposure and male fetal sex hormone level: Linear model was used to analyze the relationship between pregnant PAEs exposure and male fetal umbilical cord blood sex hormone level, and to explore the potential impact of pregnant PAEs exposure on male reproductive system development.
Research results
1. Determination of 5 kinds of PAEs metabolites in urine of pregnant women: Medians of MMP, MEP, MBzP, MEHP in urine of 232 pregnant women in the third trimester of pregnancy were 49.51 ug/L, 13.19 ug/L, 7.22 ug/L, 0.30 ug/L, 30.03 ug/L, and 110.40 ug/g, 27.61 ug/g, 16.90 ug/g, 0, 53 ug/g, 56.23 ug/g, respectively.
2. Correlation between PAEs exposure during pregnancy and pregnancy outcomes: In the correlation analysis between fetal growth and maternal PAEs exposure, neonatal weight was negatively correlated with maternal urinary MMP, MEP and_PAEs (r =-0.28, P 0.05; R =-0.14, P 0.05; P 0.05; R =-0.25, P 0.001), and neonatal length was negatively correlated with MEP level (r =-0.14, P = 0.05). After preterm delivery, the relationship between PAEs exposure during pregnancy and the growth and development outcomes of 176 full-term infants was further analyzed. Pearson correlation analysis and multiple linear regression analysis showed no neonatal weight. There was a statistical correlation between body length and the contents of five PAEs metabolites in mother's urine. The risk of premature delivery was reduced by OR = 0.31 (0.17-0.57). Multivariate logistic regression analysis showed that the relationship between DEHP exposure during pregnancy and premature delivery was still statistically significant OR = 0.23 (0.08-0.64).
3. Correlation between maternal exposure to PAEs and male fetal sex hormone levels: The mean levels of T, E2, P, FSH, LH, INSL 3 and SHBG in umbilical cord blood of male fetuses were 182.76ng/dl, 5078.62 pg/ml, 779.18 ng/ml, 1.50 IU/L, 3.11 IU/L, 135.29 pg/ml and 98.78 nmol/L, respectively. The results showed that the level of E2 in umbilical cord serum of male fetus was positively correlated with BBzP exposure during pregnancy (beta = 0.083, P = 0.03). T/E2 was negatively correlated with BBzP exposure (beta = - 0.065, P = - 0.07).
research conclusion
In this study, the detection rate of 5 kinds of PAEs metabolites was high (63.8% ~ 99.1%), indicating that pregnant women in Tianjin were generally exposed to a variety of PAEs. Different types of PAEs during pregnancy were harmful to fetal growth and reproductive system. MMP and MEP may affect neonatal weight, body length, maternal DEHP exposure reduced the risk of premature delivery, and BBzP outbreak during pregnancy. Exposure affects the level of sex hormones in male newborns.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R114
【引證文獻】
相關(guān)碩士學位論文 前1條
1 陳燕芬;PVC密封圈中ESBO的遷移研究和TTC安全評估方法的初步建立[D];暨南大學;2015年
，本文編號：2223258
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