Abstract：
BACKGROUND: The purpose of this study was to analyse the association between stannum exposure during pregnancy and congenital heart diseases in offspring.
METHODS: Based on a prospective birth cohort study conducted in Gansu Maternal and Child Health Hospital from 2010 to 2012, 14,359 pregnant women were followed up using a nested case-control study method. 97 pregnant women whose offspring were diagnosed with CHDs were used as the case group, and 194 pregnant women whose offspring did not suffer from congenital heart diseases were used as the control group in a ratio of 1:2 according to their age and place of birth. Inductively coupled plasma mass spectrometry was used to determine elemental stannum in blood samples from pregnant women hospitalized for delivery and in fetal cord blood samples. Multifactorial logistic regression analysis was used to assess the association between stannum and offspring CHDs.
RESULTS: There was a moderate positive correlation between the concentration of stannum in pregnant women\'s blood and that in umbilical cord blood. A higher concentrations of maternal blood stannum level was associated with a greater risk of CHDs (aOR 3.409, 95%CI 1.785-6.826), isolated CHDs (aOR 4.044, 95%CI 1.803-9.070), multiple CHDs (aOR 2.625, 95%CI 1.137-6.061), patent ductus arteriosus (aOR 2.882, 95%CI 1.443-5.756), atrial septal defects (aOR 3.067, 95%CI 1.406-6.690), ventricular septal defects (aOR 7.414, 95%CI 1.414-38.874). There was a correlation between the maternal and cord blood sample suggesting stannum crosses the placenta.
METHODS: Based on a prospective birth cohort study conducted in Gansu Maternal and Child Health Hospital from 2010 to 2012, 14,359 pregnant women were followed up using a nested case-control study method. 97 pregnant women whose offspring were diagnosed with CHDs were used as the case group, and 194 pregnant women whose offspring did not suffer from congenital heart diseases were used as the control group in a ratio of 1:2 according to their age and place of birth. Inductively coupled plasma mass spectrometry was used to determine elemental stannum in blood samples from pregnant women hospitalized for delivery and in fetal cord blood samples. Multifactorial logistic regression analysis was used to assess the association between stannum and offspring CHDs.
RESULTS: There was a moderate positive correlation between the concentration of stannum in pregnant women\'s blood and that in umbilical cord blood. A higher concentrations of maternal blood stannum level was associated with a greater risk of CHDs (aOR 3.409, 95%CI 1.785-6.826), isolated CHDs (aOR 4.044, 95%CI 1.803-9.070), multiple CHDs (aOR 2.625, 95%CI 1.137-6.061), patent ductus arteriosus (aOR 2.882, 95%CI 1.443-5.756), atrial septal defects (aOR 3.067, 95%CI 1.406-6.690), ventricular septal defects (aOR 7.414, 95%CI 1.414-38.874). There was a correlation between the maternal and cord blood sample suggesting stannum crosses the placenta.
摘要：
背景：本研究的目的是分析妊娠期锡暴露与后代先天性心脏病之间的关系。
方法：基于甘肃省妇幼保健院2010-2012年进行的前瞻性出生队列研究，采用巢式病例对照研究方法对14359名孕妇进行随访。97名后代被诊断为冠心病的孕妇作为病例组，根据年龄和出生地，以1:2的比例将194名后代没有先天性心脏病的孕妇作为对照组。电感耦合等离子体质谱法用于确定住院分娩的孕妇血液样品和胎儿脐带血样品中的元素锡。使用多因素逻辑回归分析来评估锡与后代CHD之间的关联。
结果：孕妇血液中的锡浓度与脐带血中的锡浓度呈中度正相关。母体血锡浓度较高与CHD风险较大相关(aOR3.409,95CI1.785-6.826),孤立性CHD(aOR4.044,95CI1.803-9.070),多个CHD(AOR2.625，95CI1.137-6.061)，动脉导管未闭（aOR2.882，95CI1.443-5.756），房间隔缺损(aOR3.067,95CI1.406-6.690),室间隔缺损（aOR7.414，95CI1.414-38.874）。母体和脐带血样本之间存在相关性，表明锡穿过胎盘。
方法：基于甘肃省妇幼保健院2010-2012年进行的前瞻性出生队列研究，采用巢式病例对照研究方法对14359名孕妇进行随访。97名后代被诊断为冠心病的孕妇作为病例组，根据年龄和出生地，以1:2的比例将194名后代没有先天性心脏病的孕妇作为对照组。电感耦合等离子体质谱法用于确定住院分娩的孕妇血液样品和胎儿脐带血样品中的元素锡。使用多因素逻辑回归分析来评估锡与后代CHD之间的关联。
结果：孕妇血液中的锡浓度与脐带血中的锡浓度呈中度正相关。母体血锡浓度较高与CHD风险较大相关(aOR3.409,95CI1.785-6.826),孤立性CHD(aOR4.044,95CI1.803-9.070),多个CHD(AOR2.625，95CI1.137-6.061)，动脉导管未闭（aOR2.882，95CI1.443-5.756），房间隔缺损(aOR3.067,95CI1.406-6.690),室间隔缺损（aOR7.414，95CI1.414-38.874）。母体和脐带血样本之间存在相关性，表明锡穿过胎盘。
