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首页> 外文期刊>Paediatric and perinatal epidemiology >Immunological exposures in Norwegian agriculture and pre-eclampsia.
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Immunological exposures in Norwegian agriculture and pre-eclampsia.

机译：挪威农业和先兆子痫的免疫暴露。

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Immune system perturbations are involved in pre-eclampsia pathophysiology. We hypothesised that immunomodulating substances, such as mycotoxins, endotoxins or pesticides, affect pre-eclampsia risk. Associations between indicators of immunomodulating exposures in agriculture and pre-eclampsia are reported. In a Norwegian family cohort based on participants in agricultural censuses conducted by Statistics Norway 1969-89, 183 313 pregnancies to farmers were identified in the Medical Birth Registry of Norway. Cases notified as pre-eclampsia as well as pregnancies indicated by hypertension in combination with proteinuria were included. Data on farm production and meteorologically based fungal forecasts 1973-90 (a marker of temperate and humid climatic conditions known to favour fungal growth and mycotoxin formation in grain) were obtained and allocated to each farm. Pre-eclampsia prevalence rates were studied in strata of exposure indicators using Poisson regression models. Adjusted rate ratios (RR) and 95%confidence intervals [CI] were computed. We identified 4912 cases, equivalent to 26.8 pre-eclampsia cases per 1000 pregnancies [95% CI 26.1, 27.6]. Pre-eclampsia showed moderate associations with animal farming, RR 1.14, [95% CI 1.07, 1.22] and moderate negative associations with grain production, RR 0.93, [95% CI 0.86, 1.01], and two or more fungal forecasts appearing in any year 1973-90, RR 0.90 [95% CI 0.84, 0.97], using no years with two or more forecasts as reference. Exposure to immunomodulating substances as indicated by grain farming, animal farming and fungal warnings could possibly have moderate effects on pre-eclampsia risk, thus supporting the study hypothesis. The use of exposure indicators as surrogates for real exposures may introduce a non-differential misclassification of the exposure that would attenuate any true exposure-outcome association. The use of exposure proxies warrants that inferences from the study should be made with caution.
机译：子痫前期病理生理学涉及免疫系统的扰动。我们假设免疫调节物质，例如霉菌毒素，内毒素或杀虫剂会影响先兆子痫的风险。据报道，在农业和先兆子痫中免疫调节暴露的指标之间存在关联。在根据挪威统计局1969-89年进行的农业普查参与者的挪威家庭队列中，挪威医疗出生登记处确定了183313例农民怀孕。包括子痫前期和高血压合并蛋白尿的孕妇。获得了农场产量和基于气象的真菌预报1973-90的数据（已知有利于谷物中真菌生长和真菌毒素形成的温带和潮湿气候条件的标志），并将其分配给每个农场。使用泊松回归模型研究了暴露指标分层中的子痫前期患病率。计算调整后的比率（RR）和95％置信区间[CI]。我们确定了4912例，相当于每1000例妊娠中有26.8例先兆子痫[95％CI 26.1，27.6]。子痫前期与畜牧业呈中等程度的关联，RR 1.14，[95％CI 1.07，1.22]，与谷物产量呈中等程度的负相关性，RR 0.93，[95％CI 0.86，1.01]，并且在任何情况下均出现两个或多个真菌预测1973-90年，RR 0.90 [95％CI 0.84，0.97]，没有使用两个或多个预测的年份作为参考。如谷物种植，动物种植和真菌警告所表明的那样，暴露于免疫调节物质可能对先兆子痫风险有中等程度的影响，因此支持了研究假说。使用暴露指标作为实际暴露的替代指标可能会导致暴露的非差异误分类，从而削弱任何真实的暴露结果关联。使用暴露代理可以保证从研究中得出谨慎的结论。

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