目的 了解温室作业这部分特殊人群长期多种农药暴露对新生儿出生质量的影响。方法 随机抽取2010年3月-2014年12月期间在潍坊市妇幼保健院等3家单位产科生育住院,在孕前及孕期累计且连续从事温室作业至少2年以上的孕妇439人及其孕产的新生儿431人纳入暴露组,不从事温室作业并且不接触农药的同医院产妇152人及其孕产的新生儿151人为对照组。通过问卷调查和查阅资料等方式获得从事大棚种植女性菜农的农药暴露情况、产妇一般情况等,通过现场调查和历史常规资料分析获得新生儿出生质量资料。根据累积农药暴露指数将蔬菜大棚种植组所有被调查者按暴露水平分为低、中、高暴露三个组。结果 新生儿男女性别比是1.09∶1,胎龄(39.46±0.28)周,出生体重平均(3.06±0.86)kg,各项体格发育指标如身高、头围、胸围等均在正常值范围内。临床 Agpar评分,1 min评分>7分占89.52%,5 min评分>7分占92.61%,10 min评分>7分占 95.36%。亚健康出生儿103名(占17.70%)、出生缺陷儿7名(占1.89%)。不同农药暴露组之间新生儿胎龄、出生体重、身长、Agpar评分、亚健康儿的差异具有统计学意义,并且对照组和高暴露组之间比较亦具有统计学差异。结论 温室作业农药暴露可以引发早产、低出生体重儿、身长和Agpar评分降低等生殖健康损伤以及可能增加后代先天性畸形的风险。

Objective To explore effects of long-term multiple pesticide exposure in the greenhouse on the birth quality of newborns. Methods The delivery women were randomly selected from the department of obstetrics and gynecology of 3 hospitals in Weifang during the period from March 2010 to December 2014.Among them,439 women farmers who had been continually working more than two years in the greenhouse during progestation and gestation with their 431 newborns were selected as exposure group;and 152 delivery women who didn't contact pesticide and engage in greenhouse with their 151 newborns were selected as control group.Informations about women farmers who were engaged in vegetable greenhouses were collected through questionnaire survey and look up data,which included the situation of pesticide exposure,the general situation of maternal and so on.The data were acquired about birth quality of newborns through field investigation and the conventional analysis of historical data.According to the cumulative pesticide exposure index,the exposure group was divided into low,media and high exposure group. Results About the newborns,sex ratio was 1.09∶1,gestational age (39.46±0.28) weeks,birth weight (3.06±0.86)kg.All morphological indexes such as height,head circumference,chest circumference were within the normal range.About the Agpar score,the rate of 1 minute score >7 points was 89.52%,the 5 minutes score > 7 points accounted for 92.61%,10 minutes score >7 points was 95.36%.There were 103 sub-health newborns,accounted for 17.70% of the newborns,and 7 birth defects accounted for 1.89%.The differences of gestational age,birth weight,body length,Agpar score and the sub-health newborns were statistically significant among the three exposed groups.Altogether,there were statistically significant between the high exposure group and the control group. Conclusion The pesticide exposure in the greenhouse can cause reproductive health damage such as premature birth,low birth weight,reduce the body length and Agpar score; and it may also increase the risk of congenital malformation of offspring.