Preconception maternal exposure: Risk of fetal and infant losses

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UDC: 
614.876:614.1
Authors: 

S.F. Sosnina, P.V. Okatenko, M.E. Sokolnikov

Organization: 

Southern Urals Biophysics Institute, 19 Ozyorskoe shosse, Ozyorsk, 456783, Russian Federation

Abstract: 

Safety of female personnel exposed to occupational radiation is still a topical issue of radiation epidemiology. Mayak Production Association is the first Russian atomic enterprise and women made a quarter of its personnel. Fetal and infant losses (FILs) that include stillbirths and infant mortality could be used as an important criterion for assessing the effects of maternal preconception (prior to conception) exposure.

The aim of this study was to assess FILs risk among the offspring of female Mayak PA workers exposed to occupational preconception external gamma-radiation.
A retrospective analysis was performed among 15307 children born in 1949–1973; mothers of 4880 of them were Mayak PA workers. FILs were analyzed taking into account sex of the offspring, period of their birth, nosologies, parental age, and dose categories of preconception exposure. Methods of non-parametrical statistics were used and calculation of relative risk was performed with 95 % confidence interval.

In general, fetal and infant losses demonstrated no statistical differences, 44.5 for 103 in the main group, 38.7 for 103 in the reference group, χ2 =2.79, p = 0.95. A statistically significant increase of FILs, stillbirths and infantile mortality was detected among the offspring with only their mothers working at Mayak PA. Dynamics analysis established the period from 1949 to 1953, in which FILs, stillbirths and infantile mortality were higher among the offspring of exposed mothers. Statistically significant differences in the FILs structure were obtained for fetal death that was more often registered in the main group, 3.48 vs 1.34 for 103, χ2 = 7.54, p = 0.006. FILs risk among mothers working at Mayak PA aged under 20 was statistically significantly higher for girls, 2.42 (1.25–4.67), and for both sexes, 2.16 (1.37–3.4). FILs were associated with the dose range of preconception external gamma-radiation of mothers from 0.16 mGy to 3006 mGy. The study also established certain categories of preconception exposure of the ovaries with significantly higher stillbirth risk in the main group as opposed to the reference one.

Keywords: 
fetal and infant losses, stillbirths, infant mortality, offspring of exposed individuals, radiation, preconception exposure, dose to the gonads, external gamma-radiation, Mayak PA
Sosnina S.F., Okatenko P.V., Sokolnikov M.E. Preconception maternal exposure: risk of fetal and infant losses. Health Risk Analysis, 2024, no. 3, pp. 78–88. DOI: 10.21668/health.risk/2024.3.09.eng
References: 
  1. Yamada M., Furukawa K., Tatsukawa Y., Marumo K., Funamoto S., Sakata R., Ozasa K., Cullings H.M. [et al.]. Congenital Malformations and Perinatal Deaths Among the Children of Atomic Bomb Survivors: A Reappraisal. Am. J. Epi-demiol., 2021, vol. 190, no. 11, pp. 2323–2333. DOI: 10.1093/aje/kwab099
  2. Signorello L.B., Mulvihill J.J., Green D.M., Munro H.M., Stovall M., Weathers R.N., Mertens A.C., Whitton J.A. [et al.]. Stillbirth and neonatal death in relation to radiation exposure before conception: a retrospective cohort study. Lancet, 2010, vol. 376, no. 9741, pp. 624–630. DOI: 10.1016/S0140-6736(10)60752-0
  3. Shmatova Yu.Е., Razvarina I.N., Gordievskaya А.N. Maternal risk factors for a child’s health prior to and during pregnancy (results of long-term cohort monitoring in Vologda region). Health Risk Analysis, 2022, no. 3, pp. 143–159. DOI: 10.21668/health.risk/2022.3.14.eng
  4. Little M.P., Goodhead D.T., Bridges B.A., Bouffler S.D. Evidence relevant to untargeted and transgenerational effects in the offspring of irradiated parents. Mutat. Res., 2013, vol. 753, no. 1, pp. 50–67. DOI: 10.1016/j.mrrev.2013.04.001
  5. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann. ICRP, 2007, vol. 37, no. 2–4, pp. 1–332. DOI: 10.1016/j.icrp.2007.10.003
  6. Jordan B. [Hiroshima / Nagasaki survivors and their offspring: results of longterm epidemiological studies]. Med. Sci. (Paris), 2018, vol. 34, no. 2, pp. 171–178. DOI: 10.1051/medsci/20183402016 (in French).
  7. Ivanov D.O., Shevtsova K.G. Analysis of selected statistical indicators of the North-Western Federal district in aspect of infant mortality and stillbirths. Pediatr, 2018, vol. 9, no. 2, pp. 5–15. DOI: 10.17816/PED925-15 (in Russian).
  8. Katsova G.B., Sergeev I.N., Kameneva V.A. The ways of perfecting of delivery of health care newborn. Vostochno-evropeiskii nauchnyi zhurnal, 2019, no. 4–1 (44), pp. 23–24 (in Russian).
  9. Terletskaya R.N. Fetoinfantile losses — from myths to reality. Rossiiskii pediatricheskii zhurnal, 2022, vol. 25, no. 4, pp. 236–241. DOI: 10.46563/1560-9561-2022-25-4-236-241 (in Russian).
  10. Stram D.O., Sokolnikov M., Napier B.A., Vostrotin V.V., Efimov A., Preston D.L. Lung Cancer in the Mayak Workers Cohort: Risk Estimation and Uncertainty Analysis. Radiat. Res., 2021, vol. 195, no. 4, pp. 334–346. DOI: 10.1667/RADE-20-00094.1
  11. Koshurnikova N.A., Kabirova N.R., Bolotnikova M.G., Petrushkina N.P., Shil’nikova N.S., Sokol’nikov M.T, Va-silenko E., Kuznetsova I. [et al.]. Characteristics of the Registry of people who lived near Mayak PA as children. Мedical Radi-ology and Radiation Safety, 2003, vol. 48, no. 2, pp. 27–34 (in Russian).
  12. Sosnina S.F., Kabirova N.R., Okatenko P.V., Rogacheva S.A., Tsareva Yu.V., Gruzdeva E.A., Sokolnikov M.E. Ozyorsk children's health registry: development results, management guidelines, potential and prospects. Meditsina ekstremal'nykh situatsii, 2017, vol. 61, no. 3, pp. 95–103 (in Russian).
  13. Tsareva Yu.V., Okatenko P.V. Mortality structure of Ozyorsk population in 1948–2013. Voprosy radiatsionnoi be-zopasnosti, 2023, no. 1 (109), pp. 60–66 (in Russian).
  14. Napier B.A. The Mayak Worker Dosimetry System (MWDS-2013): an introduction to the documentation. Radiat. Prot. Dosimetry, 2017, vol. 176, no. 1–2, pp. 6–9. DOI: 10.1093/rpd/ncx020
  15. Starodubov V.I., Sukhanova L.P. New criteria of Birth: medical and demographical outcomes and organizational problems of obstetric services. Menedzher zdravookhraneniya, 2013, no. 12, pp. 21–29 (in Russian).
  16. Sosnina S.F., Okatenko P.V., Fomin E.P., Koshurnikova N. Index of stillbirth and infant mortality in the cohort of Ozyorsk residents. Voprosy radiatsionnoi bezopasnosti, 2014, no. 2 (74), pp. 68–76 (in Russian).
  17. Sosnina S.F., Kabirova N.R., Sokolnikov M.E., Okatenko P.V. Hemoblastoses in offspring of radiation-hazardous in-dustries workers. Health Risk Analysis, 2016, no. 4, pp. 23–30. DOI: 10.21668/health.risk/2016.4.03.eng
  18. Doyle P., Maconochie N., Roman E., Davies G., Smith P.G., Beral V. Fetal death and congenital malformation in babies born to nuclear industry employees: report from the nuclear industry family study. Lancet, 2000, vol. 356, no. 9238, pp. 1293–1299. DOI: 10.1016/S0140-6736(00)02812-9
  19. Gao W., Liang J.-X., Yan Q. Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study. J. Assist. Reprod. Genet., 2015, vol. 32, no. 8, pp. 1179–1186. DOI: 10.1007/s10815-015-0490-6
  20. Lowe S.A. Ionizing radiation for maternal medical indications. Prenat. Diagn., 2020, vol. 40, no. 9, pp. 1150–1155. DOI: 10.1002/pd.5592
  21. Baleva L.S., Sipyagina A.E. Urgent problem of our time: the risk of developing radiation-induced stochastic diseases in the generations of children from irradiated parents. Rossiiskii vestnik perinatologii i pediatrii, 2019, vol. 64, no. 1, pp. 7–14. DOI: 10.21508/1027-4065-2019-64-1-7-14 (in Russian).
  22. Isakova P.V. Analysis of prevalence, structure and risk factors of infant mortality in the Russian Federation. Problemy standartizatsii v zdravookhranenii, 2017, no. 5–6, pp. 43–54 (in Russian).
  23. Olesova V.N., Olesov E.E., Olesov A.E. Stomatologicheskaya zabolevaemost' rabotnikov opasnykh proizvodstv (kliniko-epidemiologicheskie i organizatsionno-ekonomicheskie aspekty) [Dental morbidity of workers in hazardous industries (clinical-epidemiological and organizational-economic aspects)]. Moscow, A.I. Burnazyan Federal Medical Biophysical Center of the FMBA of Russia Publ., 2021, 288 p. (in Russian).
  24. Osipov M.V., Fomin E.P., Sokolnikov M.E. Evaluation of effects of diagnostic exposure using data from epidemio-logical registry of Ozyorsk population exposed to computed tomography. Meditsinskaya radiologiya i radiatsionnaya bezopas-nost', 2020, vol. 65, no. 4, pp. 65–73. DOI: 10.12737/1024-6177-2020-65-4-65-73 (in Russian).
Received: 
11.06.2024
Approved: 
13.09.2024
Accepted for publication: 
20.09.2024

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