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[背景]证据表明,持久性环境污染物可能具有生殖毒性,因此对那些可测定污染暴露的夫妇需要进行前瞻性研究。[目的]在受孕时间进行检测,探讨选定的持久性污染物与夫妇生殖力的关系。[方法]前瞻性随访一个含501对夫妇的队列,参加者终止避孕以受孕。随访为期12个月或直到一次绒毛膜促性腺激素(hCG)测试证实怀孕。这些夫妇记录生活方式日志,并提供生物样本用于定量分析血清中9种有机氯农药、1种多溴联苯、10种多溴联苯醚、36种多氯联苯(PCBs)和7种全氟化合物(PFCs)。采用离散时间Cox模型,分别估计每一对伴侣的受孕几率比(FORs)和95%CIs,以年龄、体质指数、血清可铁宁、血脂(PFCs除外)以及研究地点(密歇根州或德克萨斯州)校正血清持久性有机污染物浓度;敏感性模型进一步校正入组前的左截断和避孕时间(≤2个月)。[结果]校正后,受孕能力下降与经对数转换的血清浓度标准差增加相关联:在女性中,PCB同系物118、167、209和全氟辛烷磺酰胺的血清浓度范围介于18%~21%;在男性中,p,p’-DDE和PCB同系物138、156、157、167、170、172、209的血清浓度范围介于17%~29%。女性中与PCB 167(0.79;95%CI:0.64~0.97)的相关性最强,男性中与PCB 138(0.71;95%CI:0.52~0.98)的相关性最强。[总结]在这个以夫妻为基础的前瞻性队列研究中,采用孕前入组并对男女双方的暴露进行量化,观察到持久性环境化学品的一个亚组与生殖能力降低相关联。
[Background] Evidence indicates that persistent environmental contaminants may be reproductively toxic and therefore prospective studies are needed for couples whose measurable exposure to contamination is probable. [Objective] To test the time of conception to explore the relationship between the selected persistent pollutants and the couple’s fecundity. [Method] A prospective follow-up of a cohort of 501 couples was terminated by participants to conceive. Follow-up period of 12 months or until a chorionic gonadotropin (hCG) test confirmed pregnancy. The couple recorded lifestyle logs and provided biological samples for the quantitative analysis of nine organochlorine pesticides, one PBB, 10 PBDEs, 36 PCBs and 7 perfluorinated compounds (PFCs) in serum, . The discrete-time Cox model was used to estimate the probability of pregnancy (OR) and 95% CIs for each partner, with age, body mass index, serum cotinine, blood lipids (PFCs) and study site (Michigan or Texas ST) corrected for serum concentrations of persistent organic pollutants; the sensitivity model further adjusted for left truncation and contraception before enrollment (≤2 months). [Results] After correction, the decline in conception was associated with an increased standard deviation of logarithmic conversion serum concentrations of PCB homologs 118, 167, 209 and perfluorooctane sulfonamide in the range of 18% ~ 21%; in males, serum concentrations of p, p’-DDE and PCB homologues 138, 156, 157, 167, 170, 172, 209 ranged from 17% to 29%. The strongest correlation was found among women with PCB 167 (0.79; 95% CI: 0.64-0.97) and PCB 138 (0.71; 95% CI: 0.52-0.98) among men. [Summary] In this prospective cohort-based cohort study, pre-pregnancy enrollment and quantification of both male and female exposures were observed and one subgroup of persistent environmental chemicals was observed associated with reduced reproductive capacity.