全氟化合物孕晚期暴露与早产的关联及其影响因素

江海湛; 许飞燕; 卢亘华; 谢彦奇; 唐翠兰; 楚楚; 蔡丹; 董光辉; 曾晓雯; 黄金波

doi:10.13421/j.cnki.hjwsxzz.2025.07.001

全氟化合物孕晚期暴露与早产的关联及其影响因素

Association and influencing factors between prenatal perfluoroalkyl substance exposure and preterm birth

摘要

摘要:
目的探讨全氟化合物(perfluoroalkyl substance, PFAS)孕期暴露与新生儿早产的关联, 并对其影响因素进行探究, 为早产的预防和新生儿健康管理提供科学依据。
方法选取2015年1月—2018年12月于广东省茂名市妇幼保健院产检并生产的孕妇为研究对象(N=1 269), 采集孕晚期血, 收集问卷信息以及新生儿数据。测定孕晚期血中PFAS浓度, 采用多因素Logistic回归分析模型分析PFAS与早产的关联性, 并通过分层回归, 探讨其关联的影响因素。
结果 PFAS孕期暴露增加新生儿早产风险, PFOA、支链和直链PFOS每增加一个Ln-单位, 早产风险(95%CI)分别增加46%(25%, 71%)、46%(26%, 70%)和28%(11%, 48%); 且分娩方式、就业、家庭收入与大部分PFAS对早产有显著的交互作用(P_交互 < 0.1), 产次 < 2、pre-BMI < 18.5会增加PFOA与早产风险的关联。
结论孕期暴露于全氟化合物会增加新生儿早产的发病风险; 且孕妇Pre-BMI、产次、分娩方式、是否就业及家庭收入会影响PFAS与早产的关联。

Abstract:
Objective To investigate the association between prenatal perfluoroalkyl substance (PFAS) exposure and preterm birth (PTB) and its influencing factors, and to provide a scientific basis for PTB prevention and health management of the newborns.
Methods The study population comprised 1 269 pregnant women who received prenatal care and delivered at the Maoming Maternal and Child Health Hospital, Guangdong Province, China between January 2015 and December 2018. Late-pregnancy blood samples, along with questionnaire data and neonatal data, were collected. The PFAS concentrations in the blood samples were measured, and the multivariate logistic regression model was used to analyze the association between PFAS and PTB. The influencing factors for the association were explored by the hierarchical regression method.
Results Prenatal exposure to PFAS increased the risk of PTB. The risk of PTB increased by 46% (95% confidence interval CI: 25%, 71%), 46% (95%CI: 26%, 70%), and 28% (95%CI: 11%, 48%) for each ln-unit increase of perfluorooctanoic acid (PFOA) and branched and linear perfluorooctane sulfonate, respectively. Moreover, the delivery mode, employment status, and family income had significant interactions with most PFASs on the risk of PTB (P_inter < 0.1), and the strong association between PFOA and PTB was found in the groups of parity < 2 and pre-body mass index (BMI) < 18.5.
Conclusion Prenatal exposure to PFAS increases the risk of PTB, and the pre-BMI, parity, delivery mode, employment status, and family income of the pregnant women influence the association between PFAS and PTB.

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