Iranian Journal of Health and Environment
سلامت و محیط زیست
ijhe
Medical Sciences
http://ijhe.tums.ac.ir
1
admin
2008-2029
2008-3718
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jalali
1404
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gregorian
2025
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بررسی مواجهه مادران باردار با سرب، کادمیوم و جیوه و اثر آن بر وزن تولد و رشد نوزادان در اراک، ایران
Assessment of exposure of pregnant mothers in Arak city to heavy metals lead, cadmium, and mercury and its effect on birth weight and infant growth relative to gestational age
عمومى
General
پژوهشي
Research
<div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span b="" lotus="" style="font-family:">زمینه و هدف:</span></b> <span b="" lotus="" style="font-family:">فلزات سنگین نظیر سرب، کادمیوم و جیوه به دلیل تجمعپذیری در بدن، سلامت مادر و جنین را تهدید میکنند. این مطالعه با هدف بررسی ارتباط مواجهه با این فلزات در زنان باردار اراک و پیامدهای تولد از جمله وزن و وضعیت رشد نوزاد انجام شد.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span b="" lotus="" style="font-family:">روش بررسی:</span></b> <span b="" lotus="" style="font-family:">مطالعهای مقطعی</span> <span b="" lotus="" style="font-family:">بر روی ۲۳۵ زن باردار ساکن اراک در سال 1403 انجام شد. معیارهای ورود شامل سن </span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""><</span></span><span b="" lotus="" style="font-family:">۱۸</span> <span b="" lotus="" style="font-family:">سال، سکونت در اراک و عدم اختلال روانی و معیارهای خروج شامل مهاجرت یا ترک شهر تعریف شد. شرکتکنندگان در دو بازه ششماهه اول و دوم بررسی شدند. اطلاعات جمعیتی و بالینی گردآوری و غلظت سرب، کادمیوم و جیوه در ادرار اندازهگیری شد. اثر فلزات بر وزن تولد و وضعیت رشد شامل نوزادان کوچکتر</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""> (SGA) </span></span><span b="" lotus="" style="font-family:">و بزرگتر</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">(LGA)</span></span><span b="" lotus="" style="font-family:"> از سن حاملگی با رگرسیون خطی و لجستیک و کنترل عوامل مخدوشگر شامل سن، تحصیلات و شاخص توده بدنی تحلیل شد</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span b="" lotus="" style="font-family:">یافتهها:</span></b> <span b="" lotus="" style="font-family:">میانگین وزن تولد نوزادان </span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">g</span></span><span b="" lotus="" style="font-family:"> 3232/5</span> <span b="" lotus="" style="font-family:">بود؛ 10/64 درصد</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">SGA </span></span><span b="" lotus="" style="font-family:"> و3/40 درصد</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">LGA </span></span><span b="" lotus="" style="font-family:"> بودند. میانگین غلظت سرب </span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">μg/L</span></span> <span b="" lotus="" style="font-family:">0/48</span>±<span b="" lotus="" style="font-family:">0/84، جیوه </span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">μg/L</span></span><span b="" lotus="" style="font-family:"> 1/40</span>±<span b="" lotus="" style="font-family:">2/64 و کادمیوم </span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">μg/L</span></span><span b="" lotus="" style="font-family:"> 0/36</span>±<span b="" lotus="" style="font-family:">0/80</span><span b="" lotus="" style="font-family:">بود. مواجهه با کادمیوم در اوایل و اواخر بارداری با کاهش وزن تولد همراه بود و سرب در اواخر بارداری اثر منفی داشت. در ششماهه اول، سرب</span> <span b="" lotus="" style="font-family:">(0/0275</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">, p=</span></span><span b="" lotus="" style="font-family:">1/026 </span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">OR=</span></span><span b="" lotus="" style="font-family:">)</span> <span b="" lotus="" style="font-family:">و کادمیوم</span> <span b="" lotus="" style="font-family:">(0/0216</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">, p =</span></span><span b="" lotus="" style="font-family:">1/044 </span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">OR =</span></span><span b="" lotus="" style="font-family:">) با افزایش خطر</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""> SGA </span></span><span b="" lotus="" style="font-family:">و جیوه (0/044</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">, p =</span></span><span b="" lotus="" style="font-family:">1/042 </span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">OR =</span></span><span b="" lotus="" style="font-family:">)</span> <span b="" lotus="" style="font-family:">با افزایش خطر</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""> LGA </span></span><span b="" lotus="" style="font-family:">مرتبط بودند</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span b="" lotus="" style="font-family:">نتیجهگیری:</span></b><span b="" lotus="" style="font-family:"> مواجهه با کادمیوم و سرب باعث کاهش وزن تولد و افزایش خطر</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""> SGA </span></span><span b="" lotus="" style="font-family:">و</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""> LGA </span></span><span b="" lotus="" style="font-family:">میشود؛ یافتهها بر ضرورت کاهش مواجهه مادران باردار با فلزات سنگین تأکید دارد</span><span dir="LTR" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">.</span></span><span style="font-family:"B Lotus"" lang="AR-SA"></span></span></span></span></span></span></span></span></div>
<div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">Background and Objective</span></span></b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: Heavy metals such as lead, cadmium, and mercury, due to their bio-accumulative properties, pose significant risks to maternal and fetal health. This study investigated the association between exposure to these metals among pregnant women in Arak and adverse birth outcomes, including infant birth weight and growth status.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">Materials and Methods</span></span></b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: A cross-sectional study was conducted among 235 pregnant women residing in Arak in 2024. Inclusion criteria were residence in Arak, age under 18 years, and absence of psychological or cognitive disorders; exclusion criteria included migration or leaving the city during the study period. Participants were evaluated at two intervals: the first and second halves of pregnancy. Demographic and clinical data were collected, and urinary concentrations of lead, cadmium, and mercury were measured. The effects of metal exposure on birth weight and growth status, including small-for-gestational-age (SGA) and large-for-gestational-age (LGA), were assessed using linear and logistic regression models adjusted for maternal age, education, and body mass index.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">Results:</span></span></b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""> The mean birth weight was 3,232.5 g; 10.64%of infants were classified as SGA, and 3.40%as LGA. The mean urinary concentrations of lead, mercury, and cadmium were 0.48±0.84 μg/L, 2.64 ±1.40 μg/L, and 0.36±0.80 μg/L, respectively. Cadmium exposure during both phases of pregnancy was associated with reduced birth weight, while lead showed negative effects during late pregnancy. In early pregnancy, lead (OR =1.026) and cadmium (OR = 1.044) were associated with an increased risk of SGA, whereas mercury (OR = 1.042) was associated with LGA.</span></span><span dir="RTL" style="font-family:"B Lotus"" lang="FA"></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""> Cadmium and lead exposure reduce birth weight and increase risks of SGA and LGA, highlighting the need to minimize maternal exposure to heavy metals.</span></span></span></span></span></span></span><br>
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فلزات سنگین, ادرار, بارداری, رشد جنین, وزن نوزاد
Heavy metals, Urine, Pregnancy, Fetal growth, Birth weight
579
598
http://ijhe.tums.ac.ir/browse.php?a_code=A-10-63-2&slc_lang=fa&sid=1
Behrooz
Karimi
بهروز
کریمی
karimibehroz@yahoo.com