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目的了解温室作业这部分特殊人群长期多种农药暴露对新生儿出生质量的影响。方法随机抽取2010年3月-2014年12月期间在潍坊市妇幼保健院等3家单位产科生育住院,在孕前及孕期累计且连续从事温室作业至少2年以上的孕妇439人及其孕产的新生儿431人纳入暴露组,不从事温室作业并且不接触农药的同医院产妇152人及其孕产的新生儿151人为对照组。通过问卷调查和查阅资料等方式获得从事大棚种植女性菜农的农药暴露情况、产妇一般情况等,通过现场调查和历史常规资料分析获得新生儿出生质量资料。根据累积农药暴露指数将蔬菜大棚种植组所有被调查者按暴露水平分为低、中、高暴露三个组。结果新生儿男女性别比是1.09∶1,胎龄(39.46±0.28)周,出生体重平均(3.06±0.86)kg,各项体格发育指标如身高、头围、胸围等均在正常值范围内。临床Agpar评分,1 min评分>7分占89.52%,5min评分>7分占92.61%,10min评分>7分占95.36%。亚健康出生儿103名(占17.70%)、出生缺陷儿7名(占1.89%)。不同农药暴露组之间新生儿胎龄、出生体重、身长、Agpar评分、亚健康儿的差异具有统计学意义,并且对照组和高暴露组之间比较亦具有统计学差异。结论温室作业农药暴露可以引发早产、低出生体重儿、身长和Agpar评分降低等生殖健康损伤以及可能增加后代先天性畸形的风险。
Objective To understand the effect of long-term multiple pesticide exposure on the birth quality of newborns in this special population in greenhouse operation. Methods From March 2010 to December 2014, 439 pregnant women and their pregnant women who had been in obstetrics and gynecology hospitalized in Weifang Maternal and Child Health Hospital were randomly selected. Before pregnancy and during pregnancy, 439 pregnant women who had been working in the greenhouse for at least 2 years 431 newborns were enrolled in the exposure group, non-greenhouse operation and non-contact with pesticides in hospital 152 women and 151 newborns in their mothers as control group. Through the questionnaire survey and access to information such as access to greenhouse cultivation of female farmers Pesticide exposure, the general situation of mothers, through field surveys and historical data analysis of newborn birth quality information. According to the accumulated pesticide exposure index, all respondents in the vegetable planting group were divided into three groups according to the level of exposure: low, medium and high. Results The male to female ratio of newborns was 1.09:1, gestational age (39.46 ± 0.28) weeks, mean birth weight (3.06 ± 0.86) kg, and all physical development indexes such as height, head circumference and chest circumference were within the normal range. The clinical Agpar score was 89.52% at 1 minute, 7 points at 5 minutes, 92.61% at 5 minutes and 95.36% at 10 minutes. 103 (17.70%) were born with sub-health, and 7 (1.89%) were born with birth defects. The gestational age, birth weight, height, Agpar score and sub-healthy children in different pesticide exposure groups were statistically significant, and there was significant difference between the control group and the high-exposure group. Conclusion Exposure to greenhouse pesticides may trigger reproductive health damage such as premature birth, low birth weight infants, reduced height and Agpar scores, and may increase the risk of congenital malformations in offspring.