Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Epidemiology. 2011 Jan;22(1):74-80. doi: 10.1097/EDE.0b013e3181fe759f.
Preterm births cause a large public-health burden, and air pollution is considered to be a potential risk factor. We evaluated the association between proximity to major roads (as an index for air pollution) and preterm births, classified by gestational age and specific clinical manifestations.
Data on parental information and birth outcomes were extracted from the database maintained by the perinatal hospital in Shizuoka, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,226). Using the geocoded residential information, each birth was classified on its proximity to major roads. We estimated the multivariate-adjusted odds ratios and their 95% confidence intervals (CIs) for the association of proximity to major roads with preterm births, using logistic regression.
We found positive associations between proximity to major roads and preterm births at all gestational ages. Living within 200 m increased the risk of births before 37 weeks by 1.5 times (95% CI = 1.2-1.8), birth before 32 weeks by 1.6 times (1.1-2.4), and births before 28 weeks by 1.8 times (1.0-3.2). Proximity specifically increased the risk of preterm births with preterm premature rupture of the membranes and with pregnancy hypertension.
This study demonstrates that exposure to traffic-related air pollution increases even the risk of preterm births of less than 30 weeks' gestational age and proposes a possible mechanism.
早产会对公共健康造成巨大负担,而空气污染被认为是一个潜在的危险因素。我们评估了靠近主要道路(作为空气污染的指标)与早产之间的关联,早产按胎龄和具体临床表现进行分类。
从日本静冈县围产期医院的数据库中提取了父母信息和出生结局数据。我们将分析仅限于 1997 年至 2008 年间分娩的活产单胎母亲(n=14226)。利用地理编码的居住信息,根据每条出生的临近主要道路情况进行分类。我们使用逻辑回归估计了靠近主要道路与早产之间关联的多变量调整比值比及其 95%置信区间(CI)。
我们发现,靠近主要道路与所有胎龄的早产之间存在正相关关系。居住在 200 米以内会使 37 周前出生的风险增加 1.5 倍(95%CI=1.2-1.8),32 周前出生的风险增加 1.6 倍(1.1-2.4),28 周前出生的风险增加 1.8 倍(1.0-3.2)。靠近特定的道路会增加与早产相关的胎膜早破和妊娠高血压的早产风险。
本研究表明,接触交通相关的空气污染甚至会增加小于 30 周胎龄的早产风险,并提出了一种可能的机制。