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目的了解环境铅污染区婴幼儿出生前后铅暴露对其体格发育的影响。方法采用前瞻性队列研究方法,在环境铅污染区建立新婚夫妇研究队列,并进行基线调查、孕前观察、孕期随访、分娩及新生儿情况记录,在子代婴幼儿期进行体格测量和跟踪问卷调查;分别采取相应时期血样用石墨炉原子吸收法测定血铅水平;纵向分析出生前后铅暴露对婴幼儿体格发育的影响。结果婴幼儿身高Z标准分在母亲基线血铅高、低2组间,胸围Z标准分在父、母亲基线血铅高、低2组间差异有统计学意义(P<0.05);24月以内的身高增长率,在父、母亲基线血和婴幼儿血3种血铅高、低2组间差异均有统计学意义(P<0.05)。不同血样的血铅水平与体格发育指标Z标准分和身高增长率均呈负相关。结论环境铅暴露导致的婴幼儿体格发育迟缓与出生后暴露和出生前宫内暴露有关,与父母亲体内基线铅负荷过高有关,防治铅对儿童的危害应在出生前就开始。
Objective To understand the influence of lead exposure on physical development of infants and young children in environmental lead pollution area before and after birth. Methods A prospective cohort study was conducted to establish a cohort of newlyweds in a polluted area of environmental lead and to conduct baseline surveys, pre-pregnancy observations, follow-up visits during pregnancy, childbirths and neonatal records, and physical measurements and follow-up surveys in infancy Respectively; blood lead levels were determined by graphite furnace atomic absorption spectrometry in the corresponding period; and the effects of lead exposure before and after birth on physical development of infants were analyzed. Results The height Z score of infants and young children was higher in baseline and lower blood lead level of maternal. There was a statistically significant difference between the two groups (P <0.05) Height growth rate, there was significant difference between the two groups (P <0.05). Blood lead levels in different blood samples were negatively correlated with Z-scores and height growth rates of physical development. Conclusion The physical retardation of infants and young children caused by environment lead exposure is related to postnatal exposure and intrauterine exposure before birth. It is related to the excessive baseline lead load in parents and prevention of lead exposure to children should be started before birth.