Marshall Elizabeth G, Harris Gerald, Wartenberg Daniel
Department of Epidemiology, UMDNJ-School of Public Health, Piscataway, NJ 08854, USA.
Birth Defects Res A Clin Mol Teratol. 2010 Apr;88(4):205-15. doi: 10.1002/bdra.20650.
Evidence links exposure to ambient air pollution during pregnancy, particularly gaseous pollutants and particulate matter, to an increased risk of adverse reproductive outcomes though the results for birth defects have been inconsistent.
We compared estimated exposure to ambient air pollutants during early pregnancy among mothers of children with oral cleft defects (cases) to that among mothers of controls, adjusting for available risk factors from birth certificates. We obtained ambient air pollutant data from air monitoring sites in New Jersey for carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO(2)), particulate matter <10 microm in aerodynamic diameter (PM10) and particulate matter <2.5 microm in aerodynamic diameter (PM2.5). We used values from the nearest monitor (within 40 km of the residence at birth) for controls, cleft lip with or without cleft palate (CLP) and cleft palate only (CPO).
Based on logistic regression analyses for each contaminant and all contaminants together, there were no consistent elevated associations between selected air pollutants and cleft malformations. Quartile of CO concentration showed a consistent protective association with CPO (p < 0.01). For other contaminants, confidence intervals (95%) of the odds ratios for some quartiles excluded one. CLP showed limited evidence of an association with increasing SO(2) exposure while CPO showed weak associations with increasing O3 exposure.
There was little consistent evidence associating cleft malformations with maternal exposure to ambient air pollutants. Evaluating particular pollutants or disease subgroups would require more detailed measurement of exposure and classification of cleft defects.
有证据表明,孕期暴露于环境空气污染中,尤其是气态污染物和颗粒物,会增加不良生殖结局的风险,不过关于出生缺陷的研究结果并不一致。
我们比较了唇腭裂患儿母亲(病例组)与对照组母亲在孕早期环境空气污染物的估计暴露量,并根据出生证明中的可用风险因素进行了调整。我们从新泽西州的空气监测站点获取了一氧化碳(CO)、二氧化氮(NO₂)、臭氧(O₃)、二氧化硫(SO₂)、空气动力学直径小于10微米的颗粒物(PM₁₀)和空气动力学直径小于2.5微米的颗粒物(PM₂.₅)的环境空气污染物数据。对于对照组、唇裂伴或不伴腭裂(CLP)以及仅腭裂(CPO),我们使用距离出生居住地最近(40公里内)监测站点的值。
基于对每种污染物以及所有污染物综合进行的逻辑回归分析,所选空气污染物与腭裂畸形之间没有一致的升高关联。CO浓度四分位数与CPO呈现一致的保护关联(p < 0.01)。对于其他污染物,某些四分位数的优势比置信区间(95%)包含1。CLP与SO₂暴露增加的关联证据有限,而CPO与O₃暴露增加的关联较弱。
几乎没有一致的证据表明腭裂畸形与母亲暴露于环境空气污染物有关。评估特定污染物或疾病亚组需要更详细的暴露测量和腭裂缺陷分类。