目的：探讨孕妇血铅水平对孕期并发症、新生儿神经行为和体格发育的影响。方法回顾性分析2013年6月至2014年6月丽水市妇幼保健院足月妊娠孕产妇的临床资料。该研究共纳入孕妇500例,根据孕妇入组血铅水平分为观察组(血铅水平≥100μg/L)243例和对照组(血铅水平<100μg/L)257例。比较两组孕妇的一般资料、孕期并发症以及新生儿神经行为(NABA)评分、体格发育状况。结果两组孕妇的一般情况均无统计学差异(均P>0.05),两组均衡性较好；观察组孕妇的宫缩乏力、胎儿宫内生长受限发生率均显著高于对照组(χ2值分别为9.591、11.554,均P<0.01),而两组的羊水过多、羊水过少、胎膜早破和胎盘早剥发生率均无显著性差异(χ2值分别为0.042、0.109、0.582、0.213,均P>0.05)。观察组新生儿的行为能力、主动肌张力、被动肌张力评分均显著低于对照组(t值分别为7.126、3.765、3.477,均P<0.01),两组原始反射、一般反应评分比较均无显著性差异(t值分别为1.286、0.879,均P>0.05)。观察组新生儿的胸围显著低于对照组(t=7.066,P<0.01),但两组新生儿体重、身长、头围比较均无显著性差异(t值分别为0.765、0.225、1.060,均P>0.05)。结论血铅水平异常升高的孕妇,妊娠期并发症发生率升高,且分娩的新生儿体格发育、神经行为均会受到一定的影响。%Objective To investigate the influence of blood lead in pregnant women on pregnancy complications, neurological behavior and physical development of newborns. Methods Clinical data of the pregnant women at Lishui Maternal and Child Health Hospital from June 2013 to June 2014 were retrospectively analyzed. Patients were divided into observation group ( blood lead level≥100μg/L) and control group ( blood lead level<100μg/L) according to the level of blood lead. The general information, complications of pregnancy, neonatal NABA score and physical development of two groups were compared. Results There were no significant differences between two groups ( all P>0. 05). The incidence of uterine atony and fetal growth restriction in the observation group was significantly higher than that in the control group (χ2 value was 9. 591 and 11. 554, respectively, both P<0. 01). There was no significant difference in the incidence of hydramnios, oligohydramnios, premature rupture of membranes and placental abruption between two groups (χ2 value was 0. 042, 0. 109, 0. 582 and 0. 213, respectively, all P>0. 05). The scores of behavior ability, active and passive muscle tone in the observation group were significantly lower than those in the control group (t value was 7. 126, 3. 765 and 3. 477 respectively, all P<0. 01). There was no significant difference in the score of primitive reflex and general reaction between two groups (t value was 1. 286 and 0. 879, respectively, both P>0. 05). The chest circumference in the observation group was significantly lower than that in the control group (t=7. 066,P<0. 01), but there was no significant difference in birth weight, body length and head circumference (t value was 0. 765, 0. 225 and 1. 060, respectively, all P>0. 05). Conclusion The incidence of complications increases in pregnant women with increased level of blood lead, and physical development and neurological behavior of neonates will be affected.
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