Association of prenatal pesticide exposures with adverse pregnancy outcomes and stunting in rural Bangladesh
Association of prenatal pesticide exposures with adverse pregnancy outcomes and stunting in rural Bangladesh
复制标题
DOI：
10.1016/j.envint.2019.105243
复制
发表时间：
2019-12-01
影响因子：
11.8
通讯作者：
Christiani, David C.
中科院分区：
文献类型：
--
作者：
Jaacks, Lindsay M.;Diao, Nancy;Christiani, David C.
背景资料：怀孕期间接触农药被认为会对胎儿生长产生不利影响，进而可能影响儿童的生长，但各项研究的结果并不一致，而且很少有人在发展中国家探讨这些影响。定量测定妊娠早期尿中农药生物标志物的浓度（< 16周妊娠），并估计这些浓度与早产，低出生体重，小于胎龄儿，方法：8个农药生物标志物定量尿液收集289名孕妇（年龄18-40岁）参加在孟加拉国的出生队列研究。在出生时以及大约1岁和2岁时对索引儿童进行人体测量。利用有向无环图确定最小充分调整集。使用对数二项回归估计相对危险度（RR）和95%置信区间（CI）。毒死蜱和甲基毒死蜱的代谢产物3，5，6-三氯-2-吡啶酚（TCPY）和毒死蜱和甲基毒死蜱的代谢产物4-硝基苯酚，在几乎所有女性中均检测到，几何平均值（95%CI）分别为3.17（2.82-3.56）和18.66（17.03-20.46）μ g/g肌酐。3-在19.8%和16.1%的妇女中分别检测到几种拟除虫菊酯的非特异性代谢物苯氧基苯甲酸（3-PBA）和二嗪农代谢物2-异丙基-4-甲基-6-羟基嘧啶（IMPY）。其余四种农药生物标志物在< 10%的女性中检测到。4-硝基苯酚浓度最高四分位数的妇女早产的可能性是浓度最低四分位数的妇女的3倍多：未校正RR（95%CI），3.57（1.65，7.73）。4-硝基苯酚水平最高的四分位数的妇女生下小于胎龄儿的风险也增加：经家庭收入、母亲受教育程度和母亲总能量和肉类摄入调整的RR（95%CI）为3.81（1.10，13.21）。与未检测到IMPY浓度的女性相比，检测到IMPY浓度的女性发生低出生体重儿的风险增加：校正的RR（95% CI），2.13（1.12，4.08）。我们没有观察到任何的农药生物标志物和发育迟缓之间的关联在1或2 years of age.Discussion：暴露于杀虫剂双硫磷和二嗪农在怀孕早期可能会增加不良出生结果的风险。
Background: Pesticide exposure during pregnancy is thought to adversely affect fetal growth, which in turn may impact child growth, but results have been inconsistent across studies and few have explored these effects in developing countries.Objectives: To quantify urinary concentrations of pesticide biomarkers in early pregnancy (< 16 weeks' gestation), and to estimate the association of these concentrations with preterm birth, low birth weight, small for gestational age, and stunting at similar to 1 and 2 years of age.Methods: Eight pesticide biomarkers were quantified in urine collected from 289 pregnant women (aged 18-40 years) participating in a birth cohort study in Bangladesh. Anthropometry measurements were conducted on the index child at birth and approximately 1 and 2 years of age. A directed acyclic graph was used to identify minimal sufficient adjustment sets. Log-binomial regression was used to estimate the relative risk (RR) with 95% confidence intervals (CI).Results: 3,5,6-trichloro-2-pyridinol (TCPY), a metabolite of chlorpyrifos and chlorpyrifos methyl, and 4-nitrophenol, a metabolite of parathion and methyl parathion, were detected in nearly all women with geometric mean (95% CI) values of 3.17 (2.82-3.56) and 18.66 (17.03-20.46) mu g/g creatinine, respectively. 3-phenoxybenzoic acid (3-PBA), a non-specific metabolite of several pyrethroids, and 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY), a diazinon metabolite, were detected in 19.8% and 16.1% of women, respectively. The remaining four pesticide biomarkers were detected in < 10% of women. Women in the highest quartile of 4-nitrophenol were more than 3 times more likely to deliver preterm than women in the lowest quartile: un-adjusted RR (95% CI), 3.57 (1.65, 7.73). Women in the highest quartile of 4-nitrophenol were also at increased risk of having a child born small for gestational age: RR (95% CI) adjusted for household income, maternal education, and maternal total energy and meat intake, 3.81 (1.10, 13.21). Women with detectable concentrations of IMPY were at increased risk of having a child born with low birth weight compared to women with non-detectable concentrations: adjusted RR (95% CI), 2.13 (1.12, 4.08). We observed no association between any of the pesticide biomarkers and stunting at 1 or 2 years of age.Discussion: Exposure to the insecticides parathion and diazinon during early pregnancy may increase the risk of adverse birth outcomes.