一、出生體重及懷孕週數別新生兒及嬰兒死亡率 二、探討陶斯松暴露對胎兒成長及神經行為發展之影響

1.Birth Weight- and Gestational Age-Specific Neonatal and Infant Mortality 2.Exploring the Risk of Chlorpyrifos on Fetal Growth and Neonatal Neurobehavior

謝佳容(Chia-Jung Hsieh)

指導教授 ： 陳保中

國立臺灣大學/公共衛生學院/職業醫學與工業衛生研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.02419

摘要

研究背景：農藥在世界上已被大量使用，而其主要用途是用來作為預防及殺死害蟲及用在農田作物上或居家的蟲害控制。在台灣，每年大約有500種農藥被允許使用，其使用量每年大約有10萬公噸。而在2003台灣使用最大量的農藥是有機磷殺蟲劑，其中更以陶斯松的使用量為最多。此種非持續性農藥被使用在室內及室外、都市及鄉村地區，在食物、飲用水、農田、家中、學校及公園中都能被發現。在室內的使用後，有機磷農藥都還能穩定的持續幾天或幾星期。以陶斯松為例，在室內分噴灑後其還能持續至少兩週以上。而其暴露可能的健康影響仍然尚未清楚，因此探討其健康危害就很重要。目前有三個美國的研究指出農藥暴露對於出生體重，頭圍，身長及出生週數有些微影響但未一致的結論。而其對於神經行為發展的影響在人類流行病學研究上是欠缺且上無定論的，因此此研究目的即探討有陶斯松暴露對於嬰兒生長及神經行為發展的影響。
研究設計：此研究設計是一橫斷性的研究。研究的族群是在2004年8月至2005年1月在臺北生產的孕婦及其嬰兒共81對。為了控制其他可能的影響出生結果的危險因子，我們剔除產婦年齡低於18歲或高於40歲、有抽煙史的產婦。我們在其產前即將其列入研究，並以結構性問卷進行問卷訪視、並收集母親血液、尿液及新生兒臍帶血，並分析臍帶血中陶斯松濃度，最後我們透過複迴歸統計方法探討暴露對出生結果及神經行為發展的影響。
結果：複線性迴歸統計結果發現，較高的臍帶血陶斯松濃度和較短的出生身長及較低的出生體重計有顯著的相關。而邏輯斯廻歸結果也顯示較高的臍帶血陶斯松濃度和較低出生身長及SGA 有關。

關鍵字

陶斯松 ； 出生結果 ； 有機磷 ； 出生體重 ； 頭圍 ； 身長 ； 出生週數 ； 神經行為

並列摘要

Background: Pesticides were widespread used all over the world. They were substances that were used to prevent or destroy pests, and were wildly used in agriculture on crops, and at homes for pest control. More than five hundred kinds of pesticides were licensed for use in Taiwan, and more than ten thousands metric tons of pesticides were applied annually. Organophosphates were the largest amount of used pesticides in Taiwan in 2003, and chlorpyrifos was the most one. These pesticides were used indoors and outdoors in either urban or rural areas, and could be found in food, water, agricultures, homes, schools, and parks. In the indoor settings, they could still remain stable for days or weeks; for example, chlorpyrifos could persist for at least two weeks after spreading. The potential health effect was still unknown, and exploring the health effect was important. Only three recent studies in the U.S. had reported inconsistent and slight effect on birth weight, head circumference, birth length and gestational age. The effect for neurodevelopment on human study was absence and not concluded. Thus, the aim of the study was to explore the risk of organophosphate pesticides on fetal growth and neurodevelopment.
Material and Methods: This study was a cross-sectional in design. The study populations were the mothers who gave births in Taipei between August 2004 and January 2005 and their infants. A total of 81 pregnancy women were included in the study. To control potential risk factors for adverse birth outcomes, we excluded women if they were younger than 18 years old or older then 40 years old, or had the history of cigarette smoking. We enrolled them before delivery, interviewed by a structured questionnaire, and collected mother’s blood and urine and umbilical cord blood and analysis chlorpyrifos concentration in cord blood. We shall use multiple regression models to explore the effect of chlorpyrifos exposure on birth outcomes and neurodevelopment.
Results: For multiple linear regression models, we found that the associations between birth length and birth weight and cord plasma chlorpyrifos were significantly. For multiple logistic regression models, we found that the associations between birth length and small for gestational age (SGA) and cord plasma chlorpyrifos were significantly.

並列關鍵字

Chlorpyrifos ； birth outcomes ； organophosphatesChlorpyrifos ； birth outcomes ； organophosphates ； birth weight ； head circumference ； birth length ； gestational birth weight ； head circumference ； birth length ； gestational

參考文獻

6. Liaw TB. Lee WC. Chen CJ. Trend surface analysis for cancer mapping: application to breast cancer mortality in Taiwan. Chia J Public Health. 17(6):474-484, 1998

1. Alexander GR, Kogan M, Bader D, Carlo W, Allen M, Mor J.US birth weight/gestational age-specific neonatal mortality: 1995-1997 rates for whites, hispanics, and blacks. Pediatrics 2003; 111(1):e61-6.

2. Platt RW, Joseph KS, Ananth CV, Grondines J, Abrahamowicz M, Kramer MS.A proportional hazards model with time-dependent covariates and time-varying effects for analysis of fetal and infant death. Am J Epidemiol 2004; 160(3):199-206.

3. Lemons JA. Bauer CR. Oh W. Korones SB. Papile LA. Stoll BJ. Verter J. Temprosa M. Wright LL. Ehrenkranz RA. Fanaroff AA. Stark A. Carlo W. Tyson JE. Donovan EF. Shankaran S. Stevenson DK. Very low birth weight outcomes of the National Institute of Child health and human development neonatal research network, January 1995 through December 1996. NICHD Neonatal Research Network. Pediatrics. 107(1):E1, 2001 Jan.

4. Lubchenco LO. Searls DT. Brazie JV. Neonatal mortality rate: relationship to birth weight and gestational age. Journal of Pediatrics. 81(4):814-22, 1972 Oct.