Abstract：
Experimental evidence has indicated a correlation between in-utero exposure to neonicotinoid pesticides (NEOs) and adverse birth outcomes in mammals. However, the distribution of NEO exposure during human pregnancy, as well as its association with congenital heart diseases (CHDs), the most common birth defects, are unclear. Our purpose was to explore the distribution of and contributing factors to NEO exposure in pregnant women during early-mid pregnancy and to assess the associations between NEOs and CHDs. This nested case-control study was conducted within an ongoing prospective birth cohort study and enrolled 141 CHD singletons and their 282 individually matched controls. Six \"parent\" NEOs and three NEO metabolites were measured in maternal serum collected at an average gestational age of 16 weeks, using liquid chromatography-tandem mass spectrometry. Logistic regression was used to quantify the NEOs-CHDs associations and explore potential contributing factors to serum NEO levels in controls. N-desmethyl acetamiprid (N-dm-ACE) and imidacloprid (IMI) were the most frequently detected NEOs, found in 100% and 20% of maternal sera, respectively. We did not find a statistically significant association between total NEOs and overall CHDs. However, there was a trend towards a higher risk of septal defects with greater serum NEOs (ORs ranged from 1.80 to 2.36), especially nitro-containing NEOs represented by IMI. Pregnant women with lower education had elevated serum total NEOs compared to women with higher education (OR = 48.39, 95% CI: 23.48-99.72). Pregnant women were primarily exposed to N-dm-ACE and IMI during early-mid pregnancy. Gestational exposure to NEOs may be associated with an increased risk of septal defects, but the evidence is limited at present. Education is a potential contributing factor to NEO exposure in pregnant women. Larger and more precise studies with longitudinal biospecimen collection, are recommended to validate our exploratory findings.
摘要：
实验证据表明，子宫内暴露于新烟碱类杀虫剂（NEO）与哺乳动物的不良分娩结局之间存在相关性。然而,人类怀孕期间NEO暴露的分布，以及它与先天性心脏病（CHD）的关系，最常见的出生缺陷，不清楚。我们的目的是探讨妊娠早期中期孕妇NEO暴露的分布和影响因素，并评估NEO与CHD之间的关联。这项巢式病例对照研究是在一项正在进行的前瞻性出生队列研究中进行的，招募了141名CHD单胎和282名单独匹配的对照。在平均胎龄16周时收集的母体血清中测量了六个“父母”NEO和三个NEO代谢物，使用液相色谱-串联质谱。使用Logistic回归来量化NEO-CHD的相关性，并探索对照组血清NEO水平的潜在影响因素。N-去甲基啶虫脒（N-dm-ACE）和吡虫啉（IMI）是最常见的近地天体，在100%和20%的母体血清中发现，分别。我们没有发现总近地天体和总体冠心病之间有统计学上的显著关联。然而,血清近地天体（ORs范围从1.80到2.36）存在间隔缺损风险较高的趋势，特别是以IMI为代表的含硝基近地天体。与受过高等教育的孕妇相比，受教育程度较低的孕妇血清总NEO升高（OR=48.39，95％CI：23.48-99.72）。孕妇在妊娠早期和中期主要暴露于N-dm-ACE和IMI。妊娠接触近地天体可能会增加间隔缺损的风险,但目前证据有限。教育是孕妇接触近地天体的潜在因素。更大，更精确的研究与纵向生物标本采集，建议验证我们的探索性发现。
