摘要
目的 为探讨胎儿期铅暴露对婴儿时期体格生长的影响,以脐血铅水平作为反映胎儿期铅暴露的示标,前瞻性观察了生后12月内婴儿的体格生长状况.方法 收集有效脐血标本348份进行血铅测定,发现有40%者出生时脐血铅水平超过目前国际上公认是有害的水平(100μg/L).根据脐血铅水平将婴儿分为高铅组和低铅组,在生后3月、6月和12月龄时对其体重、身长和头围进行纵向随访.结果 我们在单因素分析中发现,高低铅组婴儿在3、6和12月龄时体重、身长和头围的离均差值均较接近,仅3月龄时体重的差别有统计学意义.用协方差分析的方法的分别校正这些影响因素后,再比较高低铅组间的差别,发现3月龄时高铅组儿童的体重仍显著落后于低铅儿童.结论 胎儿期铅暴露可能对婴儿早期的体格生长有不良影响.但这种作用在短期内为生后的其他影响因素所掩盖而显得不甚明显.
Objective We conducted a prospective investigation to assess the effects of prenatal lead exposure on infantile development of children from Yangpu District, Shanghai. Methods Totally 348 umbilical cord blood samples were collected and blood lead levels (CBPb) were determined as an indicator of prenatal lead exposure. Based on CBPb,infants were classified into two exposure groups; high lead group (CBPb> 70th percentile) and low lead group (CBPb < 30 percentile) .which were followed up at 3,6 and 12 months of age for physical growth indices including weight, height and head circumference. Results The average level of CBPb of 348 cord blood was 92 μg/L and 40. 8% of samples showed lead levels higher than 100 μg/L. Increased CBPb was significantly associated with low weight at 3rd month,which was still statistically significant after controlling for birthweight and feeding pattern. However, this difference no longer existed after 6th month. There was no obvious differences of height and head circumference between high and low lead group at all three visits. conclusion prenatal lead exposure may impact the physical growth in early stage of infant, which seem not to persist for long time.
