임신 중 내분비계 장애물질 Bisphenol A의 양수 내 농도와 임신결과와의 상관관계
Amniotic Fluid Bisphenol A Level and Its Relationship with Pregnancy Outcomes
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Bisphenol A(BPA)는 약한 estrogen 활성도를 보이는 화학물질로서 착상 전 배아나 태아에 영향을 미쳐, 출생후 그들의 신체발달에 변화를 초래한다고 알려져 있다. 본 연구는 인체에서 임신 중기에 양수 내 BPA 농도를 측정하였으며, 측정된 농도에 따라 임신결과에 영향을 미치는지 여부를 알아보고자 하였다. 임신 15주에서 20주 사이에 유전학적적응증으로 양수천자 검사를 시행 받았던 120명의 임신부 양수를 연구대상으로 ELISA 방법으로 농도를 측정하였다. 양수천자의 가장 많은 적응증은 35세 이상의 고령 임신부였다. BPA는 모든 양수에서 검출이 가능하였으며, 그 농도는 최저치 0.89 ng/mL부터 최고치 37.13 ng/mL까지의 분포를 보였고, 평균치는 7.24 ng/mL이었다. 양수 내 BPA 농도가 여러임신결과들과 관련성이 있는지를 알아보기 위해 임신부 나이 35세 이상 대 미만, 남자 태아 대 여자 태아, 분만 당시 재태연령 37주 이상 대 미만, 출생 당시 신생아 체중 2.5 kg 이상 대 미만으로 각각 나누어, 두 군간에 농도를 비교한 결과,통계학적으로 유의한 차이는 없었다. 본 연구는 한국인 임신부를 대상으로 최초로 양수 내 BPA 농도에 관한 보고이다. 본 연구결과 BPA 농도는 임신부 나이나 태아성별에 따라 차이를 보이지 않았으며, 조산이나 저체중아의 발생과도 관련이없음을 알 수 있었다. 향후 산전 BPA 노출이 배발생에 영향을 미치는지에 대한 연구가 필요하다고 사료된다.
Abstract
Bisphenol A (BPA), a chemical with weak estrogenic activity is reported to affect preimplantation embryos,fetuses and alter their postnatal development. This study amied to determine the relation between the levels of BPA in the amniotic fluid and pregnancy outcomes. ELISA was used to measure amniotic fluid BPA in 120 pregnant women who underwent genetic amniocentesis at 15～20 weeks gestation. The most common indication for amniocentesis was advanced maternal age (35 yrs or older). BPA was detected in all amniotic fluid. The range of amniotic fluid BPA concentrations was from 0.89 ng/mL to 37.13 ng/mL with a mean level of 7.24 ng/mL. We compared the means of amniotic fluid BPA concentrations according to maternal age (≥35 vs. <35 yrs), fetal sex (male vs. female), gestational age at birth (≥37 vs. <37 weeks), and infant birth weight (≥2.5 vs. <2.5 kg). No significant differences were found in these outcomes. This is the first report of amniotic fluid BPA levels in Korean pregnant women. Our findings suggest that BPA may not affect the pregnancy outcomes such as fetal sex, preterm delivery and low birth weight. Whether prenatal exposure to BPA can have teratogenic effect on developing embryo needs to be studied.
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