Preliminary analysis of in utero low-level arsenic exposure and fetal growth using biometric measurements extracted from fetal ultrasound reports.
Preliminary analysis of in utero low-level arsenic exposure and fetal growth using biometric measurements extracted from fetal ultrasound reports.
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从胎儿超声报告中提取的生物识别测量结果，对子宫低水平暴露和胎儿生长进行了初步分析。
DOI：
10.1186/1476-069x-14-12
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发表时间：
2015-03-30
期刊：
影响因子：
--
通讯作者：
Karagas MR
中科院分区：
文献类型：
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作者：
Davis MA;Higgins J;Li Z;Gilbert-Diamond D;Baker ER;Das A;Karagas MR
早期生活中暴露于砷与出生体重下降在高度暴露的人群，但鲜为人知的是低水平的砷暴露对子宫内生长的影响。我们使用来自新罕布什尔州的272例孕妇样本，直接从电子病历中常见的胎儿超声报告中获得生物特征测量值。我们使用信息提取方法来开发和验证从临床报告文本中挖掘生物特征测量的自动化方法。作为初步分析，我们研究了子宫内低水平砷暴露（通过母体尿砷浓度测量）和胎儿生长指标（根据参考人群估计的胎儿体重，头部和其他身体指标转换为Z分数）之间的关系，大约在妊娠18周。在对272例妊娠中的223例进行初步横断面分析时，（不包括砷甜菜碱）与头围Z评分降低相关（斯皮尔曼相关系数，rs =-0.08，p值= 0.21），在妊娠约18周的女性胎儿中观察到更强的相关性（rs =-0.21，p值< 0.05）。尽管在校正分析中，相关性减弱-在女性胎儿中，母体尿砷浓度增加1 μg/L与头围减少0.047（95% CI：-0.115，0.021）和双顶头直径Z评分减少0.072（95% CI：-0.151，0.007）相关。我们的研究表明，有用的数据可以直接从电子病历中提取流行病学研究。我们还发现，暴露于低水平的砷可能与减少头围在性别依赖的方式，值得进一步调查的证据。本文的在线版本（doi：10.1186/1476- 069 X-14-12）包含补充材料，可供授权用户使用。
Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero. Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth measures (converted to Z-scores based on reference populations for estimated fetal weight, head, and other body measures) at approximately 18 weeks of gestation. In a preliminary cross-sectional analysis of 223 out of 272 pregnancies, maternal urinary arsenic concentration (excluding arsenobetaine) was associated with a reduction in head circumference Z-score (Spearman correlation coefficient, rs = -0.08, p-value = 0.21) and a stronger association was observed among female fetuses at approximately 18 weeks of gestation (rs = - 0.21, p-value < 0.05). Although, associations were attenuated in adjusted analyses — among female fetuses a 1 μg/L increase in maternal urinary arsenic concentration was associated with a decrease of 0.047 (95% CI: -0.115, 0.021) in head circumference and 0.072 (95% CI: -0.151, 0.007) decrease in biparietal head diameter Z-score. Our study demonstrates that useful data can be extracted directly from electronic medical records for epidemiologic research. We also found evidence that exposure to low-level arsenic may be associated with reduced head circumference in a sex dependent manner that warrants further investigation. The online version of this article (doi:10.1186/1476-069X-14-12) contains supplementary material, which is available to authorized users.