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目的 系统评价母体砷暴露与早产的相关性。方法 通过Pubmed、Web of Science、Embase、中国知网数据库(CNKI)、万方全文数据库(WanFang Data)和维普中文期刊服务平台(VIP)进行文献检索，收集国内外发表的母体砷暴露与早产有关的流行病学研究，时限为建库开始至2022年11月。采用Stata MP15软件进行二分类变量的Meta分析，将符合纳入标准的文献进行异质性检验，根据异质性检验结果，采用随机效应模型或固定效应模型进行综合的定量分析，以比值比(OR)作为效应指标；通过亚组分析寻找其异质性来源；利用漏斗图定性评价发表偏倚。结果 最终纳入15篇文献(n=9 892 256 279),其中前瞻性队列研究10篇、回顾性队列研究3篇和横断面研究2篇。通过Meta分析，早产合并OR值(95%CI)为1.06(1.03～1.09)。依据砷暴露标志进行亚组分析，头发砷、血液砷、尿液砷、饮水砷、胎盘砷的合并OR值(95%CI)分别为0.97(0.56～1.69)、1.40(1.22～1.60)、1.04(0.93～1.17)、1.14(1.04～1.24)和0.69(0.07～6.38);依据地区进行亚组分析，亚洲、美洲、欧洲和非洲的合并OR值(95%CI)分别为1.17(1.04～1.31)、1.10(1.05～1.14)、0.69(0.07～6.38)和1.17(1.01～1.36);依据研究类型进行亚组分析，前瞻性队列研究、回顾性队列研究和横断面研究的合并OR值(95%CI)分别为1.16(1.05～1.28)、1.01(1.01～1.02)和1.65(0.73～3.74)。结论 母体砷暴露可能会导致早产的发生，饮水砷含量可能是评估人体砷暴露及致早产风险的重要指标。
Abstract：OBJECTIVE To systematic evaluate the association between maternal arsenic exposure and preterm birth.METHODS A literature search was conducted through Pubmed, Web of Science, Embase, China Knowledge Network(CNKI), WanFang Data, Vip Chinese Journal Service Platform(VIP) with a time frame of November 2022 from the beginning of database construction. Meta-analysis of dichotomous variables was performed using Stata MP15 software, and a random or fixed effects model was chosen for the meta-analysis based on the heterogeneity result, with the ratio of ratios(OR) as the effect indicator; subgroup analysis was used to find characteristic changes; funnel plots were used to evaluate publication bias.RESULTS A total of 15 papers with a sample size of(n=9 892 256 279), 10 prospective cohort studies, 3 retrospective cohort studies, and 2 cross-sectional studies, were included in 6 Chinese and 9 English papers. By Meta-analysis, the combined OR of preterm birth outcome was 1.06(95%CI 1.03-1.09); the result of subgroup analysis by exposure factors and region, the combined OR(95%CI) of hair, blood, urine, drinking water, and placenta were 0.97(0.56-1.69), 1.40(1.22-1.60), 1.04(0.93-1.17), 1.14(1.04-1.24) and 0.69(0.07-6.38). The combined OR(95%CI) were 1.17(1.04-1.31), 1.10(1.05-1.14), 0.69(0.07-6.38) and 1.17(1.01-1.36) for Asia, Americas, Europe and Africa, respectively. For subgroup analysis based on study type, the combined OR(95%CI) was 1.16(1.05-1.28), 1.01(1.01-1.02) and 1.65(0.73-3.74) for prospective cohort studies, retrospective cohort studies, and cross-sectional studies, respectively.CONCLUSION Maternal arsenic exposure may contribute to the occurrence of preterm birth, and drinking water arsenic levels may be an important indicator for assessing human arsenic exposure and risk of causing preterm birth.
[1] BLENCOWE H,COUSENS S,CHOU D,et al.Born too soon:the global epidemiology of 15 million preterm births [J].Reprod Health,2013,10 (Suppl 1):2.
[2] PARK B,KHANAM R,VINAYACHANDRAN V,et al.Epigenetic biomarkers and preterm birth [J].Environ Epigenet,2020,6(1):dvaa005.
[3] ARCELLA D,CASCIO C,GóMEZ RUIZ J.Chronic dietary exposure to inorganic arsenic [J].EFSA J,2021,19(1):e06380.
[4] BOEKELHEIDE K,BLUMBERG B,CHAPIN R E,et al.Predicting later-life outcomes of early-life exposures [J].Environ Health Perspect,2012,120(10):1353-1361.
[5] DáVILA-ESQUEDA M E,MORALES J M,JIMéNEZ-CAPDEVILLE M E,et al.Low-level subchronic arsenic exposure from prenatal developmental stages to adult life results in an impaired glucose homeostasis [J].Exp Clin Endocrinol Diabetes,2011,119(10):613-617.
[6] WANG L,YAN R,YANG Q,et al.Role of GH/IGF axis in arsenite-induced developmental toxicity in zebrafish embryos [J].Ecotoxicol Environ Saf,2020,201:110820.
[7] SHI X,AYOTTE J D,ONDA A,et al.Geospatial association between adverse birth outcomes and arsenic in groundwater in New Hampshire,USA [J].Environ Geochem Health,2015,37(2):333-351.
[8] HOU Q Z,HUANG L L,GE X T,et al.Associations between multiple serum metal exposures and low birth weight infants in Chinese pregnant women:a nested case-control study[J].Chemosphere,2019,231:225-232.
[9] HOWE C G,FARZAN S F,GARCIA E,et al.Arsenic and birth outcomes in a predominately lower income Hispanic pregnancy cohort in Los Angeles [J].Environ Res,2020,184:109294.
[10] AHMAD S A,SAYED M H,BARUA S,et al.Arsenic in drinking water and pregnancy outcomes [J].Environ Health Perspect,2001,109(6):629-631.
[11] YANG C Y,CHANG C C,TSAI S S,et al.Arsenic in drinking water and adverse pregnancy outcome in an arseniasis-endemic area in northeastern Taiwan [J].Environ Res,2003,91(1):29-34.
[12] MYERS S L,LOBDELL D T,LIU Z,et al.Maternal drinking water arsenic exposure and perinatal outcomes in inner Mongolia,China [J].J Epidemiol Community Health,2010,64(4):325-329.
[13] WAI K M,MAR O,KOSAKA S,et al.Prenatal heavy metal exposure and adverse birth outcomes in Myanmar:a birth-cohort study [J].Int J Environ Res Public Health,2017,14(11):1339.
[14] WANG H,LI J,ZHANG X,et al.Maternal serum arsenic level during pregnancy is positively associated with adverse pregnant outcomes in a Chinese population [J].Toxicol Appl Pharmacol,2018,356:114-119.
[15] RAHMAN M L,KILE M L,RODRIGUES E G,et al.Prenatal arsenic exposure,child marriage,and pregnancy weight gain:associations with preterm birth in Bangladesh [J].Environ Intern,2018,112:23-32.
[16] YU Y,GAO M,WANG X,et al.Recommended acceptable levels of maternal serum typical toxic metals from the perspective of spontaneous preterm birth in Shanxi Province,China [J].Sci Total Environ,2019,686:599-605.
[17] HUANG H,WEI L,CHEN X,et al.Cord serum elementomics profiling of 56 elements depicts risk of preterm birth:evidence from a prospective birth cohort in rural Bangladesh [J].Environ Intern,2021,156 :106731.
[18] HUANG H,WEI Y,XIA Y,et al.Child marriage,maternal serum metal exposure,and risk of preterm birth in rural Bangladesh:evidence from mediation analysis [J].J Exp Sci Environ Epidemiol,2021,31(3):571-580.
[19] REN M,ZHAO J,WANG B,et al.Associations between hair levels of trace elements and the risk of preterm birth among pregnant women:a prospective nested case-control study in Beijing Birth Cohort (BBC),China [J].Environ Int,2022,158:106965.
[20] ALMBERG K S,TURYK M E,JONES R M,et al.Arsenic in drinking water and adverse birth outcomes in Ohio [J].Environ Res,2017,157:52-59.
[21] KIM S S,MEEKER J D,CARROLL R,et al.Urinary trace metals individually and in mixtures in association with preterm birth [J].Environ Int,2018,121(Pt 1):582-590.
[22] HUANG H,WOODRUFF T J,BAER R J,et al.Investigation of association between environmental and socioeconomic factors and preterm birth in California [J].Environ Int,2018,121(Pt 2):1066-1078.
[23] FREIRE C,AMAYA E,GIL F,et al.Placental metal concentrations and birth outcomes:the Environment and Childhood (INMA) project [J].Int J Hyg Environ Health,2019,222(3):468-478.
[24] NYANZA E C,DEWEY D,MANYAMA M,et al.Maternal exposure to arsenic and mercury and associated risk of adverse birth outcomes in small-scale gold mining communities in Northern Tanzania [J].Environ Intern,2020,137:105450.
[25] WHO.IARC Monographs on the evaluation of carcinogenic risks to humans:a review of human carcinogens:arsenic,metals,fibres,and dusts [R].Lyon:IARC Press,2012,100 C:41-93.
[26] Agency for Toxic Substances and Disease Registry.ATSDR’s Substance Priority List [EB/OL].[2022-11-29].http://www.atsdr.cdc.gov/SPL/index.html.
[27] STONE J,SUTRAVE P,GASCOIGNE E,et al.Exposure to toxic metals and per- and polyfluoroalkyl substances and the risk of preeclampsia and preterm birth in the United States:a review [J].Am J Obstet Gynecol MFM,2021,3(3):100308.
[28] KHANAM R,KUMAR I,OLADAPO-SHITTU O,et al.Prenatal environmental metal exposure and preterm birth:a scoping review [J].Int J Environ Res Public Health,2021,18(2):573.
[29] PODGORSKI J,BERG M.Global threat of arsenic in groundwater [J].Science,2020,368(6493):845-850.
基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2023.05.019
中图分类号:R714.21
引用信息:
[1]吴昊,祝蓥,曹雨卉,等.母体砷暴露与早产关系的Meta分析[J].卫生研究,2023,52(05):801-807.DOI:10.19813/j.cnki.weishengyanjiu.2023.05.019.
基金信息:
国家自然科学基金(No.82381240027,81872646,81573173); 国家级大学生创新创业训练计划项目(No.202210285084P,202210285067Z); 江苏省大学生创新创业训练计划项目(No.202210285197K,202210285067Z)
2023-09-21
2023-09-21