妊娠期内分泌干扰化学物暴露与小脆弱新生儿：系统综述与荟萃分析。
完整摘要 · 中文译文
内分泌干扰化学物（EDCs）与不良出生结局有关，但流行病学研究结果仍不一致。我们开展了一项系统综述和荟萃分析，以评估妊娠期内分泌干扰化学物暴露与小型脆弱新生儿（SVNs）之间的关联，包括早产（PTB）、低出生体重（LBW）和小于胎龄儿（SGA）。检索了PubMed、Web of Science和Embase，检索时间自建库至2026年1月5日。共纳入来自31个国家的106项观察性研究，涉及98，133例出生。产前暴露于多种全氟和多氟烷基物质（PFAS）较高，包括全氟辛烷磺酸（PFOS）、全氟壬酸（PFNA）和全氟癸酸（PFDA），与早产风险增加相关，而PFOS还与低出生体重相关。全氟辛酸（PFOA）、PFNA、PFDA和全氟己烷磺酸（PFHxS）与小于胎龄儿呈正相关。在其他内分泌干扰化学物中，∑DEHP、邻苯二甲酸单-2-环己基酯（MCPP）、邻苯二甲酸单（2-乙基己基）酯（MECPP）、邻苯二甲酸单异丁酯（MiBP）和双酚A（BPA）暴露较高与早产风险增加相关。分层分析提示，在亚洲人群、女性胎儿妊娠以及未实施或仅部分实施叶酸强化国家的人群中关联更强。这些发现表明，产前暴露于PFAS和邻苯二甲酸酯可能增加小型脆弱新生儿风险，尤其是早产，且人群特征可能修饰这些关联。
完整摘要 · 英文原文
Endocrine-disrupting chemicals (EDCs) have been implicated in adverse birth outcomes, yet epidemiological findings remain inconsistent. We conducted a systematic review and meta-analysis to evaluate associations between gestational EDC exposure and small vulnerable newborns (SVNs), including preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). PubMed, Web of Science, and Embase were searched from inception to January 5, 2026. A total of 106 observational studies involving 98,133 births from 31 countries were included. Higher prenatal exposure to several per- and polyfluoroalkyl substances (PFAS), including perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), was associated with an increased risk of PTB, while PFOS was also associated with LBW. Perfluorooctanoic acid (PFOA), PFNA, PFDA, and perfluorohexanesulfonic acid (PFHxS) were positively associated with SGA. Among other EDCs, higher exposure to ∑DEHP, mono-2-cyclohexyl phthalate (MCPP), mono(2-ethylhexyl) phthalate (MECPP), monoisobutyl phthalate (MiBP), and bisphenol A (BPA) was associated with increased PTB risk. Stratified analyses suggested stronger associations in Asian populations, pregnancies with female fetuses, and countries without or with partial folic acid fortification. These findings indicate that prenatal exposure to PFAS and phthalates may increase the risk of SVNs, particularly PTB, and that population characteristics may modify these associations.