Association of DDT with spontaneous abortion: A case-control study
Association of DDT with spontaneous abortion: A case-control study
复制标题
DOI：
10.1016/s1047-2797(01)00239-3
复制
发表时间：
2001-10-01
影响因子：
5.6
通讯作者：
Xu, XP
中科院分区：
文献类型：
--
作者：
Korrick, SA;Chen, CZ;Xu, XP
目的：自然流产 (SAB) 是最常见的不良妊娠结局，其影响与临床公认的 15% 的妊娠相似。除了高龄产妇和吸烟外，尚无明确的 SAB 危险因素。动物模型将胎儿吸收增加或流产与接触农药二氯二苯三氯乙烷 (DDT) 联系起来，但 DDT 和 SAB 的流行病学调查并不一致。我们对 DDT 与 SAB 之间的假设关联进行了初步调查。 方法：这项病例对照研究的参与者是从对中国女纺织工人轮班生育影响的纵向研究中选出的，她们是已婚、年龄 22-34 岁、未生育、无 SAB 或不孕史、计划怀孕的女性。从 412 例妊娠（其中 42 例以 SAB 结束）中随机选择 15 例 SAB 病例和 15 例足月对照并进行静脉切开术。分析血清中的 p,p'-DDT、o,p'-DDT、其代谢物（DDE 和 DDD）以及包括多氯联苯在内的其他有机氯。 结果：病例和对照均为非吸烟者，并且在年龄（平均 25 岁）、体重指数 (BMI)、被动吸烟暴露或工作场所暴露方面没有差异。病例的 p,p'-DDE（22 与 12 ng/g）和 o,p'-DDE（0.09 与 0.05 ng/g）血清水平显着高于对照组（p < 0.05）。调整年龄和 BMI 后，p,p'-DDE 每增加 ng/g 血清，SAB 几率就会增加 1.13 (Cl, 1.02-1.26)。通过调整母乳喂养排泄的血清 DDE 水平，DDE 相关的 SAB 几率增加仍然显着，母乳喂养每个月母体血清 DDE 水平下降高达 7%。结论：SAB 潜在风险增加与母体血清 DDE 水平相关。 (C) 2001 Elsevier Science Inc. 保留所有权利。
PURPOSE: Spontaneous abortion (SAB), the most common adverse pregnancy outcome, affects similar to 15% of clinically recognized pregnancies. Except for advanced maternal age and smoking, there are not well-established risk factors for SAB. Animal models associate increased fetal resorption or abortion with exposure to the pesticide dichlorodiphenyl trichloroethane (DDT), but epidemiologic investigations of DDT and SAB are inconsistent. We undertook a pilot investigation of the hypothesized association of DDT with SAB.METHODS: Participants in this case-control study were selected from a longitudinal study of reproductive effects of rotating shifts among female Chinese textile workers who were married, ages 22-34, nulliparous without history of SAB or infertility, and planning pregnancy. From 412 pregnancies, 42 of which ended in SAB, 15 SAB cases and 15 full-term controls were randomly selected and phlebotomized. Serum was analyzed for p,p ' -DDT, o,p ' -DDT, their metabolites (DDE and DDD), and other organochlorines including polychlorinated biphenyls.RESULTS: Cases and controls were nonsmokers and did not differ in age (mean 25 years), body mass index (BMI), passive smoke exposure, or workplace exposures. Cases had significantly (p < 0.05) higher serum levels of p,p ' -DDE (22 vs. 12 ng/g) and o,p ' -DDE (0.09 vs. 0.05 ng/g) than controls. After adjustment for age and BMI, each ng/g serum increase in p,p ' -DDE was associated with a 1.13 (Cl, 1.02-1.26) increased odds of SAB. With adjustment of serum DDE levels for excretion via breastfeeding, DDE-associated increased odds of SAB remained significant with up to 7% declines in maternal serum DDE levels for each month of breastfeeding.CONCLUSIONS: A potential increased risk of SAB is associated with maternal serum DDE levels. (C) 2001 Elsevier Science Inc. All rights reserved.