多环芳烃暴露与围产期焦虑症状的关联

Associations of polycyclic aromatic hydrocarbons exposure with perinatal anxiety symptoms

多环芳烃暴露与围产期焦虑症状的关联

Authors: Hualong Zhen, Yunfei Jia, Beibei Zhu, Fengying Hu, Hengshun Cheng, Mengjuan Lu, Haiyan Li, Yue Gu, Yanyan Hou, Xiayan Yu, Fan Zhang, Mengqing Shang, Sheng Wang, Fangbiao Tao, Minmin Jiang

Source: Bmc Public Health

PMID: 40175925

DOI: 10.1186/s12889-025-22424-w

Abstract

Background: Polycyclic aromatic hydrocarbons (PAHs) have recently garnered attention for their possible neurotoxic effects. This study was meticulously crafted to assess the influence of PAHs exposure on the emergence of perinatal anxiety symptoms.

Methods: From April 28, 2020, to July 20, 2021, a case-control study recruiting eligible pregnant women was conducted in two primary hospitals in Hefei City, China. Professionals employed the 7-item Generalized Anxiety Disorder Scale to assess the participants' anxiety symptoms during pregnancy and postpartum via WeChat. Urinary concentrations of 12 hydroxylated PAH metabolites during pregnancy and postpartum were quantified through gas chromatography-tandem triple quadrupole mass spectrometry. Logistic regression analysis and mixed exposure modeling (BKMR model) were employed in our study to probe into the associations between PAHs exposure and perinatal anxiety symptoms.

Results: Our study incorporated 642 participants (279 cases and 363 controls). Multivariable logistic regression models revealed significant dose-response relationships between the levels of individual PAH metabolites in urine and prenatal anxiety symptoms. Compared to pregnant women in the lowest exposure tertile, those in the highest tertiles of urinary concentrations of 2-OHNA, 9-OHFLU, ∑OHFLU, 2-OHDBF, and ∑OH-PAHs had increased risk of experiencing prenatal anxiety (OR = 1.915, 95%CI: 1.271-2.886; OR = 2.084, 95%CI: 1.358-3.199; OR = 2.055, 95%CI: 1.355-3.117; OR = 1.675, 95%CI: 1.119-2.507; OR = 1.870, 95%CI: 1.228-2.847, respectively). BKMR analysis indicated a significant trend of increasing likelihood of prenatal anxiety symptoms with higher levels of the OH-PAHs mixture. Meanwhile, follow-up of 230 pregnant women until 42 days postpartum revealed that increased prenatal urinary concentrations of 2-OHFLU and ∑OHFLU were associated with a higher risk of postpartum anxiety symptoms (OR = 2.101, 95%CI: 1.000-4.414 for the medium vs. low 2-OHFLU exposure; OR = 2.277, 95%CI: 1.080-4.799 for the high vs. low ∑OHFLU exposure, respectively).

Conclusions: Our study brings to light a potentially strong positive link between PAHs exposure and perinatal anxiety symptoms.

Keywords: Case–control study; Perinatal anxiety symptoms; Polycyclic aromatic hydrocarbons; Prenatal anxiety symptoms.

摘要

背景：多环芳烃（PAHs）因其潜在的神经毒性而受到了广泛关注。本研究旨在评估多环芳烃暴露对围产期焦虑症状的不良影响。

方法：2020年4月28日至2021年7月20日，在中国合肥市的两家基层医院开展了一项病例对照研究，招募符合条件的孕妇。专业人员通过微信使用电子版广泛性焦虑障碍量表评估参与者孕期及产后的焦虑症状。采用气相色谱串联三重四极杆质谱法测定孕妇孕期和产后尿液中12种羟基多环芳烃代谢物（OH-PAHs）的浓度。本研究运用非条件logistic回归分析和混合暴露模型（BKMR模型）来探究多环芳烃暴露与围产期焦虑症状之间的关联。

结果：本研究共纳入642名参与者（279例病例和363例对照）。多变量logistic回归模型显示，尿液中单个多环芳烃代谢物水平与孕期焦虑症状之间存在显著的剂量-反应关系。与低浓度组的孕妇相比，尿液中2-羟基萘、9-羟基芴、总羟基芴、2-羟基二苯并呋喃和总羟基多环芳烃高浓度组的孕妇发生孕期焦虑的风险增加（OR = 1.915, 95%CI: 1.271-2.886; OR = 2.084, 95%CI: 1.358-3.199; OR = 2.055, 95%CI: 1.355-3.117; OR= 1.675, 95%CI: 1.119-2.507; OR = 1.870, 95%CI: 1.228-2.847）。BKMR分析表明，羟基多环芳烃混合物水平与孕期焦虑症状出现的可能性显著相关。同时，对230名孕妇随访至产后42天发现，孕期尿液中2-羟基芴和总羟基芴浓度升高与产后焦虑症状发生风险增加有关（与低暴露组相比，2-羟基芴中暴露组：OR = 2.101，95%CI：1.000-4.414；与低暴露组相比，总羟基芴高暴露组的OR = 2.277，95%CI：1.080-4.799）。

结论：本研究揭示了多环芳烃暴露与围产期焦虑症状之间可能存在较强的正相关关系。

关键词：多环芳烃；围产期焦虑症状；孕期焦虑症状；病例对照研究