摘要
[背景]大气二氧化氮(NO_(2))暴露可能会增加小于胎龄儿(SGA)和大于胎龄儿(LGA)的发生风险。然而,既往研究在推测孕期大气污染暴露影响的易感窗口时,主要是将孕期划分为相对较长的暴露时期,如孕早、中、晚期或者妊娠月。目前尚无研究探索过怀孕前后大气NO_(2)周均暴露水平与SGA和LGA发生风险的关联。[目的]评估孕前和孕期大气NO_(2)暴露对SGA和LGA发生风险的影响,并细化暴露窗口为每周,以更为准确地分析NO_(2)暴露的易感窗口。[方法]本研究依托在天津市开展的“环境和生活因素在人整个生命轨迹中对代谢健康的影响研究(ELEFANT)”项目建立出生队列,获取末次月经日期和分娩日期均在2014年6月至2016年6月期间且孕周为24~42周的10916名单胎妊娠孕妇信息。基于中国空气质量再分析数据集(CAQRA),获得每名孕妇孕前和整个孕期NO_(2)日均暴露水平。应用分布式滞后模型结合Cox比例风险回归模型,调整孕妇年龄、民族、文化程度、职业、孕前体重指数、居住地、怀孕次数、生产次数、吸烟和饮酒情况,丈夫吸烟情况,怀孕季节等潜在混杂因素,评估孕前12周和孕期NO_(2)周均暴露水平与SGA和LGA发生风险的关系。回归结果以NO_(2)每增加3μg·m^(-3),SGA和LGA发生风险的危险比(HRs)及其95%置信区间(CIs)表示。[结果]研究对象孕前期、孕早期、孕中期、孕晚期和整个孕期NO_(2)平均暴露水平分别为(39.6±10.8)、(42.7±10.5)、(44.8±12.7)、(37.7±11.1)和(41.6±4.8)μg·m^(-3)。孕早期NO_(2)暴露水平每增加3μg·m^(-3),SGA发生风险升高19.0%(95%CI:8.0%~32.0%)。孕前、孕早期和整个孕期NO_(2)暴露水平每增加3μg·m^(-3),LGA发生风险分别升高7.0%(95%CI:1.0%~13.0%)、37.0%(95%CI:29.0%~46.0%)和19.0%(95%CI:9.0%~31.0%)。SGA的NO_(2)暴露易感窗口为怀孕前第7~12周和孕期第6~12周,其中在怀孕前第12周的估计效应值最大,NO_(2)暴露水平每增�
[Background]Exposure to ambient nitrogen dioxide(NO_(2))could increase the risks of small for gestational age(SGA)and large for gestational age(LGA).Nevertheless,previous published studies usually use a time period over relatively long durations as the exposure window,such as trimester-specific or gestational months,to identify adverse pregnancy outcomes related susceptible exposure windows for ambient air pollution.At present,no study has explored associations of weekly-specific ambient air NO_(2)exposure around pregnancy with SGA and LGA.[Objective]To evaluate the associations of exposure to ambient NO_(2)over the preconception and entire pregnancy period with risks of SGA and LGA,as well as to explore critical windows of NO_(2)exposure by refining exposure period to specific weeks.[Methods]Based on a birth cohort established by the project Environmental and LifEstyle FActors iN metabolic health throughout lifecourse Trajectories(ELEFANT)situated in Tianjin,10916 singleton pregnant women whose dates of the last menstrual period and delivery were both between June 2014 and June 2016,and whose gestational age were within 24-42 completed gestational weeks were included in this study.Each pregnant woman’s exposures to ambient NO_(2)throughout 12 weeks before pregnancy and pregnancy period were matched with daily average NO_(2)concentrations obtained from the Chinese air quality reanalysis datasets(CAQRA).Distributed lag models incorporated in Cox proportional hazard regression models were applied to explore the associations of maternal exposure to weekly ambient NO_(2)throughout 12 weeks before pregnancy and pregnancy period with risks of SGA and LGA after controlling for potential confounders including maternal age,ethnicity,educational level,occupation,body mass index before pregnancy,residence,times of gravidity and parity,smoking,alcohol consumption,husband smoking,and season of conception.Hazard ratios(HRs)with 95%confidence intervals(CIs)were calculated per 3μg·m^(-3)increase in ambient NO_(2)concentratio
作者
陈娟
徐洲阳
邓芙蓉
郭新彪
郭丽琼
吴少伟
CHEN Juan;XU Zhouyang;DENG Furong;GUO Xinbiao;GUO Liqiong;WU Shaowei(Department of Occupational and Environmental Health Sciences,School of Public Health,Peking University,Beijing 100191,China;Institute of Disaster and Emergency Medicine,Tianjin University,Tianjin 300072,China;Tianjin Key Laboratory of Disaster Medicine Technology,Tianjin 300072,China;Wenzhou Safety(Emergency)Institute,Tianjin University,Wenzhou,Zhejiang 325000,China;Department of Occupational and Environmental Health,School of Public Health,Xi'an Jiaotong University,Xi'an,Shaanxi 710049,China)
出处
《环境与职业医学》
CAS
CSCD
北大核心
2022年第2期119-126,共8页
Journal of Environmental and Occupational Medicine
基金
中国国家重点研究发展计划(2018YFC1004300,2018YFC1004301)
国家自然科学基金(81971416)
天津市自然科学基金(18JCQNJC11700,18ZXDBSY00190)
关键词
二氧化氮
小于胎龄儿
大于胎龄儿
易感暴露窗
孕前
nitrogen dioxide
small for gestational age
large for gestational age
susceptible exposure window
before pregnancy
