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研究生:潘懿真
研究生(外文):I-jen Pan
論文名稱:父母親鉛暴露對於下一代出生情形的影響
論文名稱(外文):Parental Exposure to Lead and Adverse Birth Outcomes
指導教授:陳保中陳保中引用關係陳志傑陳志傑引用關係
指導教授(外文):Pau-chung ChenChih-chieh Chen
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:職業醫學與工業衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文出版年:2001
畢業學年度:89
語文別:中文
論文頁數:40
中文關鍵詞:血鉛值低出生體重早產生長遲滯
外文關鍵詞:leadlow birth weightpreterm birthsmall for gestational age
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鉛雖為一古老的金屬,但至今日鉛與其化合物在工業上仍屬重要,可是鉛對於出生結果的影響一直有所爭議,因此本研究利用血中鉛值通報資料庫獲得鉛暴露員工體內血鉛值,並連結出生通報資料檔,找出鉛暴露員工的子女出生情形,進一步分析是否雙親有職業性鉛暴露的小孩體重會減輕、出生週數減少,甚至造成低出生體重、早產以及生長遲滯的危險。完成連結後,有1611個出生個案納入研究,其皆出生於1994到1997年。依據研究結果,母親於懷孕時期的血鉛值若大於30 μg/dl 將有3.03的危險性生下生長遲滯的小孩(95%信賴區間: 1.32-6.98),父親於懷孕前的精子形成期的血鉛值大於30 μg/dl,亦有較高的危險性生下生長遲滯小孩 (勝算比2.36,95%信賴區間: 1.02-5.47),此外,隨著母親血鉛值升高,產下低出生體重的危險性亦隨著升高,但未達到統計顯著性,另外,並未發現母親或父親鉛暴露對下一代出生週數的影響。本研究的主要限制為缺乏員工的工作史及部分其他可能影響出生結果的干擾因子。
Although lead is an ancient mental, it and its compounds are still important in industry at this time. There is still debate on whether lead exposure is relative to adverse birth outcomes. We utilized the occupational blood lead notification database to obtain blood lead levels (PbBs) as an indicator of exposure and tried to assess whether offspring of parents occupationally exposed to lead would be related to decrease of birth weight, shortened gestational ages or would have an increased risks of low birth weight, preterm births, and small for gestational age. Information of birth outcome was obtained from the Taiwan birth notification database. The linkage yielded 1611 eligible births born during 1994 to 1997. Maternal blood lead levels (PbBs) during pregnancy more than 30 μg/dl had a higher risk of mothering a child of small for gestational age (odds ratio (OR) = 3.03, 95% confidence interval (95% CI) = 1.32-6.98) and paternal PbBs during spermatogenesis prior to conception more than 30 μg/dl had a higher risk of fathering a child of small for gestational age (OR = 2.36, 95% CI = 1.02-5.47). The odds ratio of low birth weight was gradually but non-significantly increased with elevated maternal PbBs. No relation was detected between maternal or paternal PbBs and length of gestation. The main limitations were lack of occupational history and inability to control other possible confounders.
1. Introduction
1.1 A Sketch of Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Routes of Exposure to Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.3 Lead Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2. Materials and Methods
2.1 Data Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
2.2 Determination of Blood Lead Level . . . . . . . . . . . . . . . . . . . . . . . . . 15
2.3 Study Outcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
2.4 Statistical Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16
3. Results
3.1 Characteristics and Birth Outcomes . . . . . . . . . . . . . . . . . . . . . .. 19
3.2 Birth Weight and Length of Gestation . . . . . . . . . . . . . . . . . . . . . 20
3.3 Risks of Low Birth Weight, Preterm Births, and SGA. . . . . . . . . 20
4. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
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