【摘要】 目的 探索母体胎盘组织中15种在用农药(CUPs)与胎儿神经管缺陷(NTDs)发生风险的关联。方法 采用病例-对照研究方法，选取308例对照和150例NTDs病例母亲作为研究对象，使用液相色谱-质谱联用技术检测母体胎盘组织中的15种在用农药的浓度，同时采用多因素Logistic回归和加权分位数之和(WQS)回归探讨胎盘的在用农药水平与NTDs发生风险的关联，采用问卷调查收集孕妇孕期农药接触和饮食习惯等信息。结果 本研究人群中15种在用农药总检出率为89.7%。多因素Logistic回归显示，高水平氟吗啉组(OR=2.58,95%CI:1.10～5.90)NTDs的发生风险显著升高，高水平吡唑醚菌酯组(OR=0.28,95%CI:0.08～0.86)和吡虫啉组(OR=0.38,95%CI:0.15～0.90)NTDs的发生风险显著降低，但经Bonferroni校正后上述关联不再具有统计学意义。WQS回归未显示胎盘中15种在用农药混合物对胎儿NTDs发生风险存在显著的联合暴露效应(OR=0.69,95%CI:0.14～3.45)。结论 本研究人群孕期在用农药暴露十分普遍，但未发现胎盘组织中15种在用农药浓度与胎儿NTDs发生风险存在统计学关联。更多还原

【Abstract】 Objective To explore the association between 15 current used pesticides(CUPs) in maternal placenta and the risk of fetal neural tube defects(NTDs). Methods A case-control study was conducted among mothers of 308 controls and 150 NTD cases. Concentrations of 15 CUPs in placental tissues were measured by liquid chromatography-mass spectrometry. Multivariate logistic regression and weighted quantile sum(WQS) regression were used to explore the association between placental CUPs and the risk of NTDs. Questionnaire survey was used to collect information on maternal pesticide active exposure history and dietary habits during pregnancy. Results The overall detection rate of 15 CUPs was 89.7% in this study. Multivariate logistic regression showed that high level of flumorph(OR=2.58, 95%CI[1.10-5.90]) was significantly associated with a higher risk of NTDs, and high levels of pyraclostrobin(OR=0.28, 95%CI[0.08-0.86]) and imidacloprid(OR=0.38, 95%CI[0.15-0.90]) were significantly associated with lower risk of NTDs, but the associations were no longer significant after Bonferroni correction. WQS regression did not show any significant combined exposure effect of CUP mixtures on the risk of fetal NTDs(OR=0.69, 95%CI[0.14-3.45]). Conclusion Exposure to CUPs during pregnancy was quite common in this study, but no statistical association was found between placental CUPs and the risk of fetal NTDs.更多还原