Ghosh Rakesh, Rankin Judith, Pless-Mulloli Tanja, Glinianaia Svetlana
Institute of Health and Society, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
Environ Res. 2007 Nov;105(3):400-8. doi: 10.1016/j.envres.2007.03.009. Epub 2007 May 9.
Gender is known to influence pregnancy outcomes. Recent studies have reported an association between air pollution exposure and adverse pregnancy outcomes, but gender differences have not been considered. In order to assess the current evidence of the interactive effects between gender and air pollution on pregnancy outcomes we undertook a systematic literature review. Using a comprehensive list of keywords, English language articles published between 1966 and 2005 were retrieved from major databases. Additional information on gender was obtained from the study authors. Studies were included if they contained well-defined measurements of ambient air pollutants, investigated pregnancy outcomes and reported estimates by gender. In total 11 studies were included. The quality of the studies was assessed using the framework in Systematic Reviews in Health Care Meta-analysis in context and Bracken's Guidelines. Of the 11 studies, four evaluated low birth weight (LBW); one each evaluated very low birth weight and fetal growth and six examined preterm birth (PTB). Females were at higher risk of LBW: adjusted odds ratios (AOR) ranged from 1.07 to 1.62. Males were at higher risk for PTB: AORs ranged from 1.11 to 1.20. In addition, there was some evidence to suggest that the effect of air pollution on LBW is differential by gender; however, the evidence was available only from four studies. This is the first systematic review to consider gender effect. Further high quality studies are needed to establish whether these findings prevail.
众所周知，性别会影响妊娠结局。近期研究报告了空气污染暴露与不良妊娠结局之间的关联，但尚未考虑性别差异。为了评估性别与空气污染对妊娠结局的交互作用的现有证据，我们进行了一项系统的文献综述。使用一份全面的关键词列表，从主要数据库中检索了1966年至2005年间发表的英文文章。关于性别的其他信息从研究作者处获得。如果研究包含对环境空气污染物的明确定量测量、调查了妊娠结局并按性别报告了估计值，则纳入该研究。总共纳入了11项研究。使用《卫生保健系统评价中的荟萃分析背景框架》和布雷肯指南中的框架对研究质量进行评估。在这11项研究中，4项评估了低出生体重（LBW）；1项评估了极低出生体重和胎儿生长情况，6项研究了早产（PTB）。女性发生低出生体重的风险更高：调整后的优势比（AOR）范围为1.07至1.62。男性发生早产的风险更高：AOR范围为1.11至1.20。此外，有一些证据表明空气污染对低出生体重的影响存在性别差异；然而，该证据仅来自4项研究。这是第一项考虑性别效应的系统综述。需要进一步的高质量研究来确定这些发现是否普遍成立。
