暴露与不良出生结果的关联:元分析和基准剂量分析
Haoqi Jia1, Nan Jing1, Zhaomin Zhong2
1Suzhou Medical College of Soochow University, Suzhou, 215123, China; Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, China.
Environmental research
|December 12, 2025
概括
(As) 暴露显著增加了不良出生结果的风险,包括自发流产,死产和先天性心脏病. 新生儿死亡率是最敏感的指标,饮用水的安全值为27.73μg/L.
科学领域:
- 环境健康 环境健康
- 生殖毒理学 生殖毒理学
- 公共卫生政策 公共卫生政策
背景情况:
- (As) 暴露是一个普遍存在的全球健康问题.
- 之前的研究将A暴露于不良出生结果,但缺乏全面的风险评估,特别是对先天性缺陷的风险评估.
- 对于公共卫生政策来说,制定As暴露的明确安全门至关重要.
研究的目的:
- 系统地评估与暴露和不良出生结果相关的健康风险.
- 评估与暴露相关的先天性缺陷的特定风险.
- 为公共政策提出饮用水中暴露的安全门.
主要方法:
- 进行了一项元分析,搜索了5个主要数据库,查找2025年6月之前发表的研究.
- 包括76项研究,共有4,164,491名参与者.
- 用贝叶斯基准剂量 (BBMD) 分析来确定剂量反应关系并确定安全值.
主要成果:
- 暴露与不良妊娠结果有显著的关联:自发流产 (OR=1.50),死产 (OR=2.10),早产 (OR=1.19),新生儿死亡率 (OR=1.38),婴儿死亡率 (OR=1.50).
- 观察到先天性心脏病发病率显著增加 (OR=1.92) 和出生体重减少 (β=-12.67 g).
- 新生儿死亡率是最敏感的终点,在饮用水中的基准度下限 (bmcl10) 为27.73μg/L.
结论:
- 暴露与一系列不良的出生结果和发育问题密切相关.
- 饮用水中的暴露和不良妊娠结果之间存在明显的剂量反应关系.
- 建议饮用水中的安全值为27.73μg/L,以减轻风险,特别是新生儿死亡率.
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