Cleft Palate Craniofac J：母亲暴露于多环芳烃 子代易发唇裂

　　美国一项研究表明，母亲职业暴露于多环芳烃与后代发生伴或不伴腭裂的唇裂风险增加相关。该论文发表于《裂腭与颅面杂志》[Cleft Palate Craniofac J 2013，50（3）：337]。

　　该病例对照研究纳入了美国出生缺陷预防研究（NBDPS）中1997-2002年的数据。

　　结果为，入组的受试者分别为：对照组2989名（暴露率3.5%），伴或不伴腭裂的唇裂组805例（暴露率5.8%），单纯腭裂组439例（暴露率4.6%）。与对照组相比，伴或不伴腭裂的唇裂组母亲在妊娠期间职业暴露于多环芳烃的比率较高[比值比（OR）=1.69]；校正母亲受教育程度因素后，OR=1.47。经校正相关因素后，多环芳烃暴露剂量与发生伴或不伴腭裂的唇裂风险间存在显著的剂量-效应关系，而多环芳烃暴露与 单纯腭裂间无此相关性。

Maternal occupational exposure to polycyclic aromatic hydrocarbons and risk of oral cleft-affected pregnancies.
Objective
To evaluate whether there is an association between maternal occupational exposure to polycyclic aromatic hydrocarbons and oral clefts in offspring. This is the first human study of polycyclic aromatic hydrocarbons and clefts of which the authors are aware.
Design
Case-control study.
Setting, Participants
Data for 1997 to 2002 from the National Birth Defects Prevention Study, a large population-based case-control study in the United States, were analyzed. Maternal telephone interviews yielded information on jobs held in the month before through 3 months after conception. Two industrial hygienists independently assessed occupational exposure to polycyclic aromatic hydrocarbons; all jobs rated as exposed or with rating difficulty were reviewed with a third industrial hygienist to reach consensus on all exposure parameters. Logistic regression estimated crude and adjusted odds ratios with 95% confidence intervals for cleft lip with or without cleft palate and cleft palate alone.
Results
There were 2989 controls (3.5% exposed), 805 cases of cleft lip with or without cleft palate (5.8% exposed), and 439 cases of cleft palate alone (4.6% exposed). The odds of maternal occupational exposure to polycyclic aromatic hydrocarbons (any versus none) during pregnancy was increased for cleft lip with or without cleft palate cases as compared with controls (odds ratio, 1.69; 95% confidence interval, 1.18 to 2.40); the odds ratio was 1.47 (95% confidence interval 1.02 to 2.12) when adjusted for maternal education. There was a statistically significant adjusted exposure-response relationship for cleft lip with or without cleft palate (Ptrend = .02). Odd ratios for cleft palate alone were not statistically significant.
Conclusions
Maternal occupational exposure to polycyclic aromatic hydrocarbons was associated with increased risk of cleft lip with or without cleft palate in offspring.