孕期接触钡和砷与子代先天性心脏病的患病几率：中国兰州一项出生队列中的巢式病例对照研究
Prenatal exposure to barium and arsenic and the odds of congenital heart defects in offspring: a nested case-control study within a birth cohort in Lanzhou, China.
作者信息
Dang Yun, Sun Jianhao, Wu Zhenzhen, Mao Baohong, Hang Qinglei, Huang Jie, Zhao Xiaoli, Xia Ji, Chen Cheng, Yao Wenxiang, Lu Dan, Liu Qing
机构信息
Gansu Provincial Maternity and Child-Care Hospital/Gansu Provincial Central Hospital, Lanzhou, China.
Institute of Pathology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
出版信息
Front Public Health. 2025 May 1;13:1597178. doi: 10.3389/fpubh.2025.1597178. eCollection 2025.
BACKGROUND
Previous studies have identified that exposure to heavy metals increases the prevalence of congenital heart defects (CHDs); however, limited information exists regarding the association between combined exposure to barium (Ba) and arsenic (As), and CHDs. This study aims to investigate the association between prenatal exposure to Ba and As (both independently and in combination) and the risk of CHDs in offspring.
METHODS
In a birth cohort study conducted in Lanzhou, China, a total of 97 mother-newborn pairs were designated as the case group, with an additional 194 pairs constituting the control group. The concentrations of Ba and As in maternal blood were quantified utilizing an inductively coupled plasma mass spectrometer. A multivariate logistic regression model was employed to examine the association between Ba and As exposure levels and the risk of neonatal CHDs and their subtypes. Interaction effects were further evaluated through the application of both additive and multiplicative models.
RESULTS
The concentration of As in the blood of pregnant women is positively correlated with Ba levels. Higher concentrations of maternal blood Ba level was associated with greater odds of CHDs ( = 0.008), including the isolated CHDs ( = 0.013), the multiple CHDs ( = 0.032), PDA ( = 0.014), and ASDs ( = 0.031); Similarly, higher concentrations of maternal blood As level was associated with greater odds of CHDs ( = 0.013), including the isolated CHDs ( = 0.016), the multiple CHDs ( = 0.003), PDA ( = 0.005), ASDs ( = 0.017), and AVSDs ( = 0.034). Elevated levels of barium and arsenic in maternal blood were significantly associated with increased odds of CHDs and their subtypes in offspring (All < 0.05). Furthermore, a significant multiplicative interaction between Ba and As levels in maternal blood was identified in relation to total CHDs ( = 0.04).
CONCLUSION
Exposure to Ba or As individually, as well as combined exposure to both, is significantly associated with an increased risk of CHDs in offspring.
背景
先前的研究已经确定，接触重金属会增加先天性心脏病（CHD）的患病率；然而，关于钡（Ba）和砷（As）联合暴露与CHD之间的关联，现有信息有限。本研究旨在调查产前暴露于Ba和As（单独暴露以及联合暴露）与后代患CHD风险之间的关联。
方法
在中国兰州进行的一项出生队列研究中，共有97对母婴被指定为病例组，另有194对母婴构成对照组。利用电感耦合等离子体质谱仪对母体血液中的Ba和As浓度进行定量。采用多因素逻辑回归模型来检验Ba和As暴露水平与新生儿CHD及其亚型风险之间的关联。通过应用相加模型和相乘模型进一步评估交互作用。
结果
孕妇血液中As的浓度与Ba水平呈正相关。母体血液中较高的Ba水平与患CHD的较高几率相关（比值比=0.008），包括孤立性CHD（比值比=0.013）、多发性CHD（比值比=0.032）、动脉导管未闭（PDA，比值比=0.014）和房间隔缺损（ASD，比值比=0.031）；同样，母体血液中较高的As水平与患CHD的较高几率相关（比值比=0.013），包括孤立性CHD（比值比=0.016）、多发性CHD（比值比=0.003）、PDA（比值比=0.005）、ASD（比值比=0.017）和房室间隔缺损（AVSD，比值比=0.034）。母体血液中Ba和As水平升高与后代患CHD及其亚型的几率增加显著相关（所有P<0.05）。此外，在母体血液中Ba和As水平之间，就总的CHD而言发现了显著的相乘交互作用（P=0.04）。
结论
单独暴露于Ba或As，以及同时暴露于两者，均与后代患CHD的风险增加显著相关。
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