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目的了解一般孕妇人群重金属铅、镉、铬、镍的暴露水平,以及对孕妇及新生儿健康产生的影响。方法在汕头市中心医院招募20～35岁非职业暴露健康待产孕妇,测量身高、体重、血压、心率等身体指数,采集静脉血测量红细胞、白细胞、血红蛋白及血小板等生化指标。产后采集脐带血,应用石墨炉原子吸收法检测重金属铅、镉、铬及镍的含量。产后测量新生儿身长、体重、头围、胸围、胎龄及Apgar评分。以Pearson相关分析方法统计分析重金属暴露水平与孕妇、新生儿健康关系。结果共调查55对孕妇及其新生儿,孕妇平均年龄(29.63±4.48)岁,BMI为24.91±3.60;新生儿BMI为12.64±1.38,Apgar评分(9.24±0.83)分(10分为满分)。研究人群脐带血铅、镉、铬、镍的中位浓度分别为45.92、0.61、23.27、7.50μg/L。按目前通用标准,脐带血中铅超标率为7.27%(4/55),镉、铬各有1例超标,血镍无超标。血镉与血铬、血镍之间存在着相关性,在体内协同存在(r值分别为0.466、0.299)。血铅与孕妇血红蛋白呈负相关(r=-0.519);血镉与孕妇血压呈正相关(收缩压:r=0.313,舒张压:r=0.372);血铬与孕妇血小板呈负相关(r=-0.288)。血铅与新生儿Apgar评分呈负相关(r=-0.530);而血镉与新生儿体重、BMI指数呈负相关(r值分别为-0.311及-0.372)。结论受检孕妇人群血铅存在一定水平的超标,而其他重金属的超标率较低。在目前暴露水平下,显示已对孕妇及其新生儿健康产生一定影响,其确切的健康危害作用需大样本研究作进一步评估。
Objective To understand the exposure levels of lead, cadmium, chromium and nickel in general pregnant women and their effects on the health of pregnant women and newborns. Methods A total of 20 to 35-year-old non-occupational exposed healthy pregnant women were enrolled in Central Hospital of Shantou. Body mass index such as height, weight, blood pressure and heart rate were collected. Venous blood was collected to measure the biochemical indexes of red blood cells, white blood cells, hemoglobin and platelets. Umbilical cord blood was collected after delivery, and the contents of Pb, Cd, Cr and Ni in heavy metals were determined by graphite furnace atomic absorption spectrometry. Postnatal growth, body weight, head circumference, bust, gestational age and Apgar score were measured. Pearson correlation analysis was used to statistically analyze the relationship between heavy metal exposure and maternal and newborn health. Results A total of 55 pairs of pregnant women and their newborns, pregnant women, the average age (29.63 ± 4.48) years old, BMI 24.91 ± 3.60; neonatal BMI was 12.64 ± 1.38, Apgar score (9.24 ± 0.83) points (10 points for the perfect score). The median concentrations of lead, cadmium, chromium and nickel in cord blood were 45.92, 0.61, 23.27 and 7.50 μg / L, respectively. According to the current common standards, cord blood lead exceeding the standard rate of 7.27% (4/55), cadmium, chromium in each one exceeded, no nickel blood exceeded. Blood cadmium and blood chromium, nickel blood there is a correlation between the synergistic in vivo (r values were 0.466,0.299). Blood lead was negatively correlated with hemoglobin of pregnant women (r = -0.519); blood cadmium was positively correlated with blood pressure of pregnant women (systolic blood pressure: r = 0.313, diastolic blood pressure: r = 0.372) 0.288). Blood lead was negatively correlated with neonatal Apgar score (r = -0.530), while serum cadmium was negatively correlated with neonatal weight and BMI (r = -0.311 and -0.372, respectively). Conclusion There is a certain level of blood lead in pregnant women under examination, while the over-standard rate of other heavy metals is low. At the current level of exposure, it has been shown to have some effect on the health of pregnant women and their newborns, and their exact health effects need further evaluation in large sample studies.