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目的分析孕早期和孕中期PM2.5暴露与子代认知-运动发育间关联性,为孕期防护提供依据。方法选取2014年6月-2015年4月期间来本院建卡并分娩的孕妇190例,于孕期建卡时进行问卷调查,获取孕妇的居住地址、房屋类型以及楼层分布等信息,通过渗透系数获得室外PM2.5进入室内部分的浓度,作为孕期PM2.5暴露水平。并于婴儿产后42d体检时应用“年龄发育进程问卷-第三版”(ASQ-3)进行认知-运动发育水平评估。通过两独立样本t检验和多因素线性回归等方法分析孕期PM2.5暴露与子代认知-运动发育间的关联性。结果孕早期正常暴露组孕妇所生婴儿粗大运动能区得分和精细运动能区得分均高于暴露超标组婴儿,且正常暴露组婴儿五个能区总分也高于暴露超标组婴儿,差异均有统计学意义(P<0.05)。孕早期孕妇暴露PM2.5水平每增高一个单位,ASQ-3各能区得分平均降低0.53~0.62分,ASQ-3总分平均降低2.0分,且以上差异有统计学意义(P<0.05)。与孕早期的PM2.5暴露效应不同,在孕中期虽然PM2.5暴露水平增高也呈现出ASQ-3多能区得分降低的趋势,但差异无统计学意义(P>0.05)。结论相对于孕中期的PM2.5暴露,孕早期的暴露更容易对子代认知-运动发育水平产生影响,因此针对大气PM2.5的防护应从孕早期就开始并且应重点做好孕早期的暴露防护。
Objective To analyze the correlation between PM2.5 exposure in early pregnancy and second trimester and offspring cognitive-motor development, and provide evidence for the protection during pregnancy. Methods From June 2014 to April 2015, 190 pregnant women who had built their cards and gave birth in our hospital were selected. Questionnaires were made during the card-making period to obtain information such as the address of the pregnant women, the type of houses and floor distribution. Access to outdoor PM2.5 part of the indoor concentration, as PM2.5 exposure during pregnancy. At 42 days after delivery, the infant was assessed for cognitive-motor development using the “Age Developmental Process Questionnaire-Third Edition” (ASQ-3). Two independent samples t-test and multivariate linear regression analysis of PM2.5 during pregnancy exposure and offspring cognitive-motor development between the association. Results In the first trimester of pregnancy, the scores of gross motor energy score and fine motor energy of infants born to pregnant women in normal exposure group were higher than that of infants with excessive exposure, and the scores of five energy regions of normal exposed group were also higher than those of exposed infants There was statistical significance (P <0.05). In the first trimester of pregnant women exposed to PM2.5 level increased by one unit, ASQ-3 each energy district average reduction 0.53 ~ 0.62 points, ASQ-3 total score average reduction of 2.0 points, and the above difference was statistically significant (P <0.05). Different from PM2.5 exposure in the first trimester, PM2.5 exposure also showed a trend of decrease in scores of ASQ-3 pluripotency in the second trimester, but the difference was not statistically significant (P> 0.05). Conclusions Exposure to PM2.5 in early pregnancy is more likely to have an impact on offspring cognitive-motor development than PM2.5 exposure in the second trimester, so protection against atmospheric PM2.5 should start early in pregnancy and should focus on early-stage Exposure protection.