摘要
目的分析孕妇妊娠期细颗粒物(PM_(2.5))及其组分[有机碳(OC)、元素碳(EC)、铵盐(NH_(4)^(+))、硝酸盐(NO_(3)^(-))和硫酸盐(SO_(4)^(2-))]暴露对早产的影响。方法基于在北京市通州区妇幼保健院建立的前瞻性出生队列,通过问卷收集2018年3月至11月期间怀孕的4360名孕妇的人口学资料和生活方式等信息,通过医疗记录收集妊娠期合并症及新生儿分娩孕周、出生体重、性别等分娩信息。利用改进的多尺度空气质量(CMAQ)模型评估孕妇妊娠期的PM_(2.5)及其组分暴露情况。使用Cox比例风险回归模型分析妊娠期PM_(2.5)及其组分暴露对早产的影响。结果本研究共209名(4.8%)孕妇早产。校正孕妇年龄、教育水平、工作情况、民族、产次、孕前是否超重肥胖、孕早期吸烟及饮酒、妊娠期合并症、新生儿性别等混杂因素后,妊娠期PM_(2.5)、OC、EC、NH_(4)^(+)、NO_(3)^(-)、SO_(4)^(2-)每增加一个四分位间距,早产发生风险分别增加至1.499倍(95%CI:1.340~1.678)、1.469倍(95%CI:1.324~1.629)、1.153倍(95%CI:1.082~1.228)、1.518倍(95%CI:1.350~1.707)、1.700倍(95%CI:1.470~1.965)、1.507倍(95%CI:1.332~1.705)。结论妊娠期PM_(2.5)及其组分暴露会导致早产风险增加。研究结果为阐明PM_(2.5)及其组分暴露对早产风险的影响提供流行病学证据,同时为促进PM_(2.5)防控标准的制定提供科学依据。
Objective To investigate the effects of fine particulate matter(PM_(2.5))and its constituents[organic carbon(OC),elementary carbon(EC),ammonium(NH_(4)^(+)),nitrate(NO_(3)^(-))and sulfate(SO_(4)^(2-))]exposure during pregnancy on preterm birth.Methods A prospective birth cohort was established in Tongzhou Maternal and Child Health Care Hospital of Beijing,China.A total of 4360women who became pregnant from March to November 2018were included in the cohort.The information of demographic characteristics and lifestyle-related factors was collected through the questionnaires.Complications during pregnancy and birth information such as gestational age,birth weight,and gender were collected through medical records.Modified community multiscale air quality model was used to estimate the concentrations of PM_(2.5)and its constituents during pregnancy.Cox proportional hazard regression models were used to analyze the associations between PM_(2.5)and its constituents exposure during pregnancy and the risk of preterm birth.Results In this study,209(4.8%)birth were preterm birth.After adjusting for maternal age,maternal educational level,employment,ethnicity,parity,pre-pregnancy overweight or obesity,smoking and drinking during the first trimester,pregnancy complications and sex of newborns,an IQR increase in PM_(2.5),OC,EC,NH_(4)^(+),NO_(3)^(-),and SO_(4)^(2-)during pregnancy was associated with increased risk of preterm birth,with HRs of 1.499(95%CI:1.340-1.678),1.469(95%CI:1.324-1.629),1.153(95%CI:1.082-1.228),1.518(95%CI:1.350-1.707),1.700(95%CI:1.470-1.965),and 1.507(95%CI:1.332-1.705),respectively.Conclusion Exposure to PM_(2.5)and its constituents during pregnancy is significantly associated with the increased risk of preterm birth.The study results can provide epidemiological evidence for elucidating the effects of PM_(2.5)and its constituents on preterm birth and provide scientific basis for promoting the establishment of the regulation of PM_(2.5).
作者
韩娜
周双
李湉湉
张翼
李钦
计岳龙
刘珏
王辉
胡建林
刘婷
王海俊
HAN Na;ZHOU Shuang;LI Tiantian;ZHANG Yi;LI Qin;JI Yuelong;LIU Jue;WANG Hui;HU Jianlin;LIU Ting;WANG Haijun(Department of Obstetrics and Gynecology,Tongzhou Maternal and Child Health Care Hospital of Beijing,Beijing101101,China;Department of Maternal and Child Health,School of Public Health,Peking University,Beijing100191,China;National Institute of Environmental Health,Chinese Center for Disease Control and Prevention,Beijing100021,China;Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing100191,China;Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control,Collaborative Innovation Center of Atmospheric Environment and Equipment Technology,Nanjing University of Information Science&Technology,Jiangsu Nanjing 210044,China)
出处
《中国妇幼健康研究》
2023年第4期47-53,共7页
Chinese Journal of Woman and Child Health Research
基金
国家自然科学基金项目(81973053)。
关键词
细颗粒物
组分
早产
队列
fine particulate matter
constituents
preterm birth
cohort
