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暴露和子宫内生长限制之间的关联:系统性审查和元分析

Jing Jiang^1,2, Xuan Zuo^1,2, Songlin An^1,3

¹School of Public Health, Zunyi Medical University, Zunyi, China.

|June 2, 2025

概括

暴露与妊娠年龄 (SGA) 较小的出生风险增加有关,特别是在亚洲. 公共卫生政策的目标应该是减少孕妇在怀孕期间接触的风险.

科学领域:

环境健康环境健康
生殖流行病学生殖流行病学
毒理学毒理学毒理学

背景情况:

观察性研究表明 (As) 暴露与子宫内生长限制 (IUGR) 之间存在联系,但研究结果不一致.
流行病学数据的异质性需要对As-IUGR关联进行系统的评估.

研究的目的:

系统地评估暴露与子宫内生长限制 (IUGR) 结果之间的关联,包括怀孕年龄相对小 (SGA),早产 (PTB) 和低出生体重 (LBW).
确定异质性的来源,并评估检查暴露和IUGR的研究中的出版偏见.

主要方法:

对11项涉及2,183,652名参与者的研究进行了元分析,搜索了6个数据库,截至2024年5月.
使用NOS,AHRQ和NTP/OHAT工具评估了偏见风险. 随机效应或固定效应模型被用于元分析.
用子组,元回归,Egger,Begg测试和漏斗图来分析异质性和出版偏差.

主要成果:

在暴露和SGA之间发现了显著的关联 (OR:1.06,95%CI:1.00,1.13),特别是在亚洲 (OR:1.28,95%CI:1.10,1.49).
母亲暴露于更高的水平 (10-100μg/L) 与SGA显著相关 (OR:1.25,95% CI:1.04,1.50).
特定的暴露水平与增加的PTB (1-10μg/L) 和LBW (0-1μg/L) 风险有关,尽管整体关联并不显著.

结论:

暴露与IUGR的风险增加有关,主要是SGA.
小组分析表明,特定的暴露水平会增加PTB和LBW风险.
这些发现强调需要采取更严格的公共卫生政策,以减轻怀孕期间的暴露,同时承认潜在的异质性和出版偏见.

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