摘要 目的研究孕期铊暴露与孕妇孕期血压水平变化及妊娠期高血压的关联。方法于2013年5月至2014年9月,以在马鞍山市妇幼保健院首次建立孕产妇保健手册且符合纳入排除标准的3240名孕妇作为研究对象。通过问卷调查、查阅孕产妇保健手册及病历记录、实验室检测等方法收集一般人口学特征、血压、血清中铊浓度等信息。采用多因素logistic回归模型分析不同孕期铊暴露水平与妊娠期高血压疾病(HDCP)的关联;采用混合线性效应模型分析不同孕期铊暴露水平与孕妇孕期收缩压(SBP)/舒张压(DBP)的关联。结果3240名对象年龄为(26.61±3.64)岁,HDCP检出率为5.9%(191/3240)。孕早、中、晚期孕妇外周血血清中铊浓度M(P25,P75)分别为62.96(50.79,77.04)、62.19(50.87,75.26)、48.84(38.00,66.00)ng/L。多因素logistic回归模型分析结果显示,调整相关混杂因素后,孕早期高水平铊暴露(>77.04 ng/L)的孕妇发生HDCP的风险是低水平暴露(<50.79 ng/L)孕妇的1.75倍(95%CI:1.01~3.03);混合线性效应模型分析结果显示,孕早期孕妇外周血血清中铊浓度与DBP呈正相关,β(95%CI)值为1.12(0.39~1.85)。结论孕早期高水平铊暴露可增加HDCP的发生风险,孕早期铊暴露可影响孕妇孕期DBP。 Objective To investigate the association of thallium exposure during pregnancy with pregnant blood pressure changing and hypertensive disorder complicating pregnancy(HDCP).Methods A total of 3240 pregnant women who had establish maternal health care manual in Ma′anshan Maternal and Child Health-Care Hospital and met the inclusion and exclusion criteria were included in this study between May 2013 and September 2014.We collected their general demographic characteristics and blood pressure through questionnaire and medical records.Meanwhile we measured serum thallium concentrations by experimental technology.We use multiple logistic regression to analyze the association between thallium exposure during pregnancy and HDCP.Mixed linear model were used to analyze the association between thallium concentration and maternal systolic blood pressure(SBP)or diastolic blood pressure(DBP)in different trimesters Results The age of 3240 pregnant woman was(26.61±3.64)years,and the detection rate of HDCP was 5.9%(191).The median(P25,P75)of thallium concentrations in first trimester,second trimester and third trimester were 62.96(50.79,77.04),62.19(50.87,75.26),48.84(38.00,66.00)ng/L,respectively.Multiple logistic regression results suggested after adjusting various confounding factors,the risk of HDCP in pregnant women with high concentrations of thallium(>77.04 ng/L)in the first trimester is 1.75(95%CI:1.01-3.03)times higher than which with low concentrations(<50.82 ng/L).Mixed linear model results suggested there are positive correlation between thallium concentrations with maternal DBP in first trimester(β=1.12,95%CI:0.39-1.85).Conclusion Exposure to high levels of thallium during first trimester may increase the risk of HDCP,and the exposure of thallium may be effective to DBP of pregnant.
出处 《中华预防医学杂志》 CAS CSCD 北大核心 2021年第5期646-652,共7页 Chinese Journal of Preventive Medicine
基金 国家重点研发计划(2016YFC1000204-2) 国家自然科学基金(81803260)。
分类号 R71 [医药卫生—妇产科学]
