目的 探究妊娠妇女新烟碱类农药（neonicotinoid pesticides，NEOs）的暴露情况及其与亚临床甲状腺功能减退（subclinical hypothyroidism，SCH）发生风险的相关性。 方法 本研究采用病例对照设计，以2020年1月至2021年12月在重庆医科大学附一院酉阳医院进行产前检查的21例SCH孕妇（SCH病例组）及37例正常孕妇（对照组）为研究对象，采用液相色谱串联质谱法检测其血清中8种常见NEOs的浓度。使用单因素分析（独立样本t检验）探究妊娠妇女血清单一NEO浓度与SCH发生风险的相关性，采用贝叶斯核机器回归模型（Bayesian Kernel Machine Regression，BKMR）分析NEOs污染物暴露对SCH发生的联合影响和交互作用。 结果 在本研究检测的8种NEOs中，呋虫胺（dinotefuran，DIN）、噻虫嗪（thiamethoxam，THX）、噻虫胺（clothianidin，CLO）、吡虫啉（imidacloprid，IMI）、氯噻啉（imidaclothiz，IMZ）在研究人群中的检出率为100%，啶虫脒（acetamiprid，ACE）的检出率为19.0%，烯啶虫胺（nitenpyram，NIT）和噻虫啉（thiacloprid，THI）未检出。THX的中位数浓度最高（2.00 μg/L）。独立样本t检验分析结果显示，所检测的5种NEOs在SCH组与对照组间的差异无统计学意义。BKMR模型显示孕妇血清NEOs混合暴露与SCH发生之间差异无统计学意义。 结论 本研究数据显示，酉阳地区妊娠妇女THX暴露程度较高；NEOs暴露与妊娠期SCH发生不存在明显关联，其对人体妊娠期甲状腺功能是否存在扰乱作用还待进一步阐明。

Objective To investigate the exposure to neonicotinoid pesticides（NEOs） and its association with the risk of subclinical hypothyroidism（SCH） in pregnant women. Methods A case-control study was conducted among 21 pregnant women with SCH（SCH case group） and 37 normal pregnant women（control group） who received prenatal examination in Youyang Hospital，The First Affiliated Hospital of Chongqing Medical University，from January 2020 to December 2021，and liquid chromatography-tandem mass spectrometry was used to measure the serum concentrations of eight common NEOs. The univariate analysis（the independent samples t-test） was used to investigate the association of the serum concentration of a single NEO with the risk of SCH in pregnant women，and the Bayesian kernel machine regression（BKMR） model was used to analyze the joint effect and interactions of exposure to NEOs pollutant on the development of SCH. Results Among the NEOs tested in this study，dinotefuran，thiamethoxam（THX），clothianidin，imidacloprid，and imidaclothiz had a detection rate of 100%，and acetamiprid had a detection rate of 19.0%，while nitenpyram and thiacloprid were not detected. The highest median concentration of THX was 2.00 μg/L. The independent samples t-test showed that there were no significant differences in the five NEOs with the detection rate of 100% between the SCH group and the control group. The BKMR model showed no statistical association between mixed exposure to serum NEOs and the onset of SCH in pregnant women. Conclusion The data from this study show a relatively high level of THX exposure among pregnant women in Youyang. There is no apparent association between NEOs exposure and the onset of SCH during pregnancy，but further studies are needed to determine whether NEOs exposure may disturb human thyroid function during pregnancy.