การศีกษาระดับการรับสัมผัสพิษจากสิ่งแวดล้อมในหญิงตั้งครรภ์ในประเทศไทย ด้วยวิธี Pooled Urine Samples
ชื่อผู้แต่งข้างต้นเป็นข้อความจากระเบียนผลงาน ไม่ได้ผูกกับรหัสนักวิจัย จึงกดดูผลงานอื่นของบุคคลนี้ไม่ได้ — ในคลังนี้ 142,080 ผลงาน (63.6% ของทั้งหมด) มีชื่อผู้แต่งที่เชื่อมกับหน้าผู้แต่งได้ และ 60,298 ผลงาน (27.0%) มีผู้แต่งที่ผูกกับรหัสนักวิจัยจริง ส่วนอีก 81,382 ผลงานไม่มีข้อมูลผู้แต่งเลย (มีชื่อผู้แต่งเป็นข้อความอยู่ 142,009 ผลงาน = 63.5%)
บทคัดย่อ
Background Pregnant women are at risk from heavy metals exposure due to physiologic changes, resulting in adverse pregnancy outcomes. Pooling approach is an approach which is beneficial in reducing financial and laboratory burden in limited-resource settings. The study aimed to assess background exposure of heavy metals among pregnant women and to evaluate the differences of urinary cadmium and lead level across geographic regions and across trimesters of pregnancy by using pooled sample analysis. Methods We collected urine samples from all nationalities pregnant women who attended the ANC clinics during two weeks in six hospitals representing six different regions of Thailand. We asked clinical staff to split 1-ml of excess urine from routine ANC care into 50-ml tubes by trimesters. The samples were analyzed for cadmium and lead level as well as cotinine as biomarkers of tobacco smoking which might be a potential source of exposure. Results Fifty-two pools samples of 2,112 individual pregnant women were collected by trimesters and by hospitals. Geometric mean for urinary cadmium and lead were 0.63?1.14 ng/mL and 0.82?1.07 ng/mL respectively. Log-transformed cadmium and lead levels were found statistical differences across the hospitals (p-value <0.0001 and 0.0014). The log-transformed urinary cadmium and lead showed the decreasing trends as trimester decreases, but they did not show statistically significant (p-value 0.66 and 0.28 respectively). Furthermore, there was a positive linear relationship between log-transformed urine lead and cotinine (p-value <0.001, r=0.38). Conclusions Our study is the first study demonstrating the pattern of cadmium, lead and cotinine exposure by using pooled urine approach among Thai pregnant women. The results indicate that environmental tobacco exposure might be a potential source of lead exposure whereas diet might be a primary source of cadmium exposure among pregnant women in Thailand. Large-Scale human biomonitoring should be developed by using pooling approach to integrate this fruitful data into national public health surveillance.