Center for Public Health Research (CSISP), Conselleria de Sanitat, 46020, Valencia, Spain.
Environ Health. 2010 Jan 29;9:6. doi: 10.1186/1476-069X-9-6.
Maternal exposure to air pollution has been related to fetal growth in a number of recent scientific studies. The objective of this study was to assess the association between exposure to air pollution during pregnancy and anthropometric measures at birth in a cohort in Valencia, Spain.
Seven hundred and eighty-five pregnant women and their singleton newborns participated in the study. Exposure to ambient nitrogen dioxide (NO2) was estimated by means of land use regression. NO2 spatial estimations were adjusted to correspond to relevant pregnancy periods (whole pregnancy and trimesters) for each woman. Outcome variables were birth weight, length, and head circumference (HC), along with being small for gestational age (SGA). The association between exposure to residential outdoor NO2 and outcomes was assessed controlling for potential confounders and examining the shape of the relationship using generalized additive models (GAM).
For continuous anthropometric measures, GAM indicated a change in slope at NO2 concentrations of around 40 microg/m3. NO2 exposure >40 microg/m3 during the first trimester was associated with a change in birth length of -0.27 cm (95% CI: -0.51 to -0.03) and with a change in birth weight of -40.3 grams (-96.3 to 15.6); the same exposure throughout the whole pregnancy was associated with a change in birth HC of -0.17 cm (-0.34 to -0.003). The shape of the relation was seen to be roughly linear for the risk of being SGA. A 10 microg/m3 increase in NO2 during the second trimester was associated with being SGA-weight, odds ratio (OR): 1.37 (1.01-1.85). For SGA-length the estimate for the same comparison was OR: 1.42 (0.89-2.25).
Prenatal exposure to traffic-related air pollution may reduce fetal growth. Findings from this study provide further evidence of the need for developing strategies to reduce air pollution in order to prevent risks to fetal health and development.
许多近期的科学研究表明，母亲在怀孕期间接触到的空气污染与胎儿的生长有关。本研究的目的是评估在西班牙巴伦西亚的一个队列中，孕妇在怀孕期间接触到的空气污染与出生时的人体测量指标之间的关联。
785 名孕妇及其单胎新生儿参加了这项研究。通过使用土地利用回归来估算环境中二氧化氮（NO2）的暴露水平。NO2 的空间估计值被调整以适应每个女性的相关怀孕期（整个孕期和三个孕期）。出生体重、身长和头围（HC）以及胎儿生长受限（SGA）是本研究的结局变量。在控制潜在混杂因素的情况下，评估了暴露于住宅室外 NO2 与结局之间的关系，并使用广义相加模型（GAM）检查了关系的形状。
对于连续的人体测量指标，GAM 表明，在 NO2 浓度约为 40μg/m3 时，斜率发生了变化。在第一个孕期中，NO2 暴露量>40μg/m3 与出生时身长的变化有关，变化幅度为-0.27cm（95%置信区间：-0.51 至-0.03），与出生体重的变化有关，变化幅度为-40.3 克（-96.3 至 15.6）；整个孕期的相同暴露与出生 HC 的变化有关，变化幅度为-0.17cm（-0.34 至-0.003）。这种关系的形状大致呈线性，与 SGA 风险有关。在第二个孕期中，NO2 每增加 10μg/m3，SGA 体重的比值比（OR）为 1.37（1.01-1.85）。对于 SGA 身长，同一比较的估计值为 OR：1.42（0.89-2.25）。
胎儿在产前接触交通相关的空气污染可能会导致胎儿生长受限。本研究的结果提供了进一步的证据，表明需要制定减少空气污染的策略，以预防对胎儿健康和发育的风险。
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