Environmental Pollution In Eastern And Central Europe

目的：这项研究的目的是评估金属、有机氯和多环芳烃污染对一个前东部集团国家生殖结果的贡献。这是为数不多的关于高环境污染和怀孕的大型研究之一。 成果：我们检查了胎盘中金属的浓度。这两个城市的铅和汞浓度相似；基辅的镉浓度略高。与许多其他国家的报告和乌克兰之前的报告相比，这两个城市的汞、铅和镉浓度都很低。砷的检测下限太高，无法与其他地区现有的少数几项研究进行有意义的比较。锌和铜的浓度与其他地方相似；基辅的锌略高于第聂伯哲尔任斯克。我们检测了七种多环芳烃在胎盘中的浓度；所有的多环芳烃在所有的胎盘中都可以检测到，除了一个胎盘中的苯并(A)芘。从一般人群中获得的比较数据很少；描述多环芳烃暴露的报告往往来自职业暴露人群，并涉及尿代谢物或DNA加合物的测量，而不是多环芳烃浓度的测量。基辅的浓度略高于第聂伯哲尔任斯克。 在完全清点和主要ELSPAC研究中，我们检查了活产儿的早产率。对于ELSPAC参与者来说，这一比例约为活产儿的5%；整个人口普查的比例略高。这两种情况与欧洲其他地区报告的情况相似，但远低于美国的情况，甚至白人也是如此。然而，试图比较早产率--通常只根据活产计算--充满了问题；乌克兰的高胎儿死亡率导致许多早产被排除在早产率的分子和分母之外，从而降低了明显的早产率。我们还检查了在其他研究中常见的早产预测因素是否预测了这一人群中的早产，而且通常是这样的。目前，正在描述怀孕期间的住院模式；住院在乌克兰比在西方普遍得多，但这可能反映了经济力量和惯常的护理模式，而不是母亲更高的严重并发症发生率。

Aims: The aim of this study is to assess the contribution of pollution by metals, organochlorines, and polycyclic aromatic hydrocarbons to reproductive outcome in a former eastern bloc country. This one of only a few large studies of high environmental pollution and pregnancy. Accomplishments: We examined concentration of metals in placenta. Lead and mercury concentrations were similar in the two cities; cadmium was somewhat higher in Kyiv. When compared to reports from many other countries and to a previous report from Ukraine, mercury, lead, and cadmium concentrations were low in both cities. The detection limit for arsenic was too high to allow meaningful comparison with the few existing studies from other regions. Zinc and copper were present at concentrations similar to those seen elsewhere; zinc was modestly higher in Kyiv than in Dniprodzerzhinsk. We examined concentrations of seven PAHs in placenta; all PAHs were detectable in all placentas, with the single exception of benzo(a)pyrene in one placenta. There is little comparative data available from general populations; reports describing PAH exposures tend to come from occupationally exposed groups and to involve measurement of urinary metabolites or of DNA adducts rather than of PAH concentrations. Concentrations were slightly higher in Kyiv than in Dniprodzerzhinsk. We examined the rate of preterm births among liveborns in both the complete enumeration and the main ELSPAC study. For ELSPAC participants, the rate was about 5 percent of live births; the rate for the entire census was slightly higher. Both are similar to rates reported elsewhere in Europe and considerably lower than US rates, even for whites. However, attempts to compare preterm rates, which conventionally are calculated on live births only, are fraught with problems; the high fetal mortality rate in Ukraine causes many preterm deliveries to be excluded from both the numerator and denominator of the preterm rate and thus lowers the apparent preterm rate. We also examined whether the predictors of preterm birth commonly seen in other studies predicted preterm birth in this population, and generally they did. Currently, patterns of hospitalization during pregnancy are being described; hospitalization is much more common in Ukraine than in the west, but this may reflect economic forces and customary patterns of care rather than higher rates of severe complications in the mothers.