Glinianaia Svetlana V, Rankin Judith, Bell Ruth, Pless-Mulloli Tanja, Howel Denise
School of Population and Health Sciences, Faculty of Medical Sciences, University of Newcastle, Newcastle-upon-Tyne, United Kigndom.
Epidemiology. 2004 Jan;15(1):36-45. doi: 10.1097/01.ede.0000101023.41844.ac.
Research on the potential impact of air pollution on the health of adults and children has grown rapidly over the last decade. Recent studies have suggested that air pollution could also be associated with adverse effects on the developing fetus. This systematic review evaluates the current level of epidemiologic evidence on the association between ambient particulate air pollution and fetal health outcomes. We also suggest further research questions.
Using database searches and other approaches, we identified relevant publications published between 1966 and 2001 in English. Articles were included if they reported original data on birthweight, gestational age at delivery, or stillbirth related to directly measured nonaccidental exposure to particulate matter.
Twelve studies met the inclusion criteria. There was little consistency in the evidence linking particulate air pollution and fetal outcomes. Many studies had methodologic weaknesses in their design and adjustment for confounding factors. Even in well-designed studies, the reported magnitude of the effects was small and inconsistently associated with exposure at specific stages of pregnancy.
The currently available evidence is compatible with either a small adverse effect of particulate air pollution on fetal growth and duration of pregnancy or with no effect. Further research should be directed toward clarifying and quantifying these possible effects and generating testable hypotheses on plausible biologic mechanisms.
在过去十年中，关于空气污染对成人和儿童健康潜在影响的研究迅速增加。最近的研究表明，空气污染也可能对发育中的胎儿产生不利影响。本系统评价评估了关于环境空气中颗粒物污染与胎儿健康结局之间关联的当前流行病学证据水平。我们还提出了进一步的研究问题。
通过数据库检索和其他方法，我们确定了1966年至2001年间以英文发表的相关出版物。如果文章报告了与直接测量的非意外颗粒物暴露相关的出生体重、分娩时的孕周或死产的原始数据，则将其纳入。
12项研究符合纳入标准。将颗粒物空气污染与胎儿结局联系起来的证据几乎没有一致性。许多研究在设计和对混杂因素的调整方面存在方法学弱点。即使在设计良好的研究中，报告的效应大小也很小，并且与孕期特定阶段的暴露之间的关联不一致。
目前可得的证据与颗粒物空气污染对胎儿生长和孕期持续时间有小的不利影响或无影响均相符。进一步的研究应致力于阐明和量化这些可能的影响，并就合理的生物学机制提出可检验的假设。
