Nested Case-control Study On The Association Of Polybrominated Diphenyl Ethers And Other Factors With Low Birth Weight

【Objective】To explore the impact of the parents’ factors,some environmental factors and polybrominated diphenyl ethers on low birth weight of newborns. Based on this,we also investigated the concentration distribution and the transport mechanism of each PBDEs homologue between maternal blood and neonatal cord blood, so as to provide base data for formulating the control strategy of low birth weight. 【Methods】A 1:3 match-control method was adopted in this study.Firstly, We built birth-cohort of pregnants and their newborns who were born in Hospital of Maternal and Child Healthcare of Xiamen, Zhongshan Hospital Affiliated to Xiamen University, Haicang Hospital of Xiamen and Lianhua Hospital of Xiamen from Jan 1, 2011 to Dec 31,2013. 5108 maternal-neonatal pairs were collected. Nested case-control study was used to screen out 86 low birth weight infants and 258 controls which was 1:3 patched on age(±1 year), newborn sex, birth time(≤10 days)and mother’s last menstrual. The questionnaire was used to survey the impact factors from patients. Meanwhile, 5ml blood samples from mothers and newborns’ umbilicus were collected to analysis the impact of the poly brominated diphenyl ethers(PBDEs) and its homolog on low birth weight using the gas chromatography.Database was established using a double entry method with Epidata 3.1 software, SPSS18.0 software package was used for data statistics and analysis. The multi-conditional logistical regression was applied in screening risk factors. Mann-Whitney U was used to describe difference of 9 PBDEs congeners concentrations between low birth weight and control group. Spearman correlation was used to investigate the relationship of different PBDEs homologue neonatal umbilical cord blood, the correlation of same PBDEs congeners between maternal 5 blood and neonatal umbilical cord blood. Wilcoxon signed-rank test was used to explore the difference of the same kind of PBDEs congeners in maternal and umbilical cord blood. 【Results】1. Multi-factor conditional logistic regression analysis for parent’s factors showed: The risk factors of LBW were gestational age < 37 weeks, eating raw garlic more than 2 times per week, Gestational hypertension, intake of antibiotics during pregnancy and increase in amplitude of gestational BMI<5. The protective factors of LBW were average family income≥4000 yuan per month.2. The level of BDE-01、BDE-99、BDE-153 in case group were significantly higher than normal birth weight group after factors of parent included in the regression as confounding factors(P<0.05).3. There was a positive correlation between the level of PBDEs homologues in neonatal umbilical cord blood(P<0.001).4. There was a positive correlation of BDE-01, BDE-15, BDE-47, BDE-100, BDE-153 and BDE-154 levels between maternal blood and umbilical cord blood(P <0.01).5. The content of BDE-100, BDE-153 and BDE-154 in the umbilical cord blood were higher than that of maternal blood(P<0.05). 【Conclusion】1. The risk factors of LBW were premature, eating raw garlic more than 2 times per week, Gestational hypertension, intake of antibiotics during pregnancy and increase in amplitude of gestational BMI<5. The protective factors of LBW were average family income≥4000 yuan per month.2. PBDE congeners of BDE-01, BDE-99 and BDE-153 in Neonatal umbilical cord blood are the risk factors of low birth weight.3. The source of PBDEs homologues in neonatal umbilical cord blood may be the same.4. BDE-01, BDE-15, BDE-47, BDE-100, BDE-153 and BDE-154 in maternal blood could be through the placenta to the fetus blood circulation. And the content of BDE-100, BDE-153 and BDE-154 in the umbilical cord blood were significantly higher than that of maternal blood.