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金属锡暴露增加后代先天性心脏病发生的风险:兰州的病例对照研究。

Metal stannum exposure increases the risk of congenital heart defects occurence in offspring: A case-control study in Lanzhou.

机构信息

The first Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China; Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China.

Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China.

出版信息

Int J Cardiol. 2024 Sep 15;411:132270. doi: 10.1016/j.ijcard.2024.132270. Epub 2024 Jun 14.

Abstract

BACKGROUND

The purpose of this study was to analyse the association between stannum exposure during pregnancy and congenital heart diseases in offspring.

METHODS

Based on a prospective birth cohort study conducted in Gansu Maternal and Child Health Hospital from 2010 to 2012, 14,359 pregnant women were followed up using a nested case-control study method. 97 pregnant women whose offspring were diagnosed with CHDs were used as the case group, and 194 pregnant women whose offspring did not suffer from congenital heart diseases were used as the control group in a ratio of 1:2 according to their age and place of birth. Inductively coupled plasma mass spectrometry was used to determine elemental stannum in blood samples from pregnant women hospitalized for delivery and in fetal cord blood samples. Multifactorial logistic regression analysis was used to assess the association between stannum and offspring CHDs.

RESULTS

There was a moderate positive correlation between the concentration of stannum in pregnant women's blood and that in umbilical cord blood. A higher concentrations of maternal blood stannum level was associated with a greater risk of CHDs (aOR 3.409, 95%CI 1.785-6.826), isolated CHDs (aOR 4.044, 95%CI 1.803-9.070), multiple CHDs (aOR 2.625, 95%CI 1.137-6.061), patent ductus arteriosus (aOR 2.882, 95%CI 1.443-5.756), atrial septal defects (aOR 3.067, 95%CI 1.406-6.690), ventricular septal defects (aOR 7.414, 95%CI 1.414-38.874). There was a correlation between the maternal and cord blood sample suggesting stannum crosses the placenta.

摘要

背景

本研究旨在分析孕妇体内锡暴露与子代先天性心脏病的关联。

方法

基于 2010 年至 2012 年在甘肃省妇幼保健院进行的前瞻性出生队列研究,采用巢式病例对照研究方法对 14359 名孕妇进行随访。97 名孕妇所生子女被诊断为 CHD 作为病例组,根据年龄和出生地,以 1:2 的比例选择 194 名未患先天性心脏病的孕妇作为对照组。采用电感耦合等离子体质谱法测定住院分娩孕妇血样和胎儿脐血样中元素锡的含量。采用多因素 logistic 回归分析评估锡与子代 CHD 的关系。

结果

孕妇血样和脐血样中锡浓度呈中度正相关。母体血锡浓度越高,CHD 发病风险越大(aOR 3.409,95%CI 1.785-6.826),单纯 CHD(aOR 4.044,95%CI 1.803-9.070),多发 CHD(aOR 2.625,95%CI 1.137-6.061),动脉导管未闭(aOR 2.882,95%CI 1.443-5.756),房间隔缺损(aOR 3.067,95%CI 1.406-6.690),室间隔缺损(aOR 7.414,95%CI 1.414-38.874)。母体和脐血样本之间存在相关性,表明锡可以穿过胎盘。

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