Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia.
Occup Environ Med. 2012 Nov;69(11):815-22. doi: 10.1136/oemed-2011-100509. Epub 2012 Jul 31.
Fetal growth restriction has been inconsistently associated with maternal exposure to elevated levels of traffic-related air pollution.
We investigated the relationship between an individualised measure of fetal growth and maternal exposure to a specific marker for traffic-related air pollution.
We estimated maternal residential exposure to a marker for traffic-related air pollution (nitrogen dioxide, NO2) during pregnancy for 23,452 births using temporally adjusted land-use regression. Logistic regression was used to investigate associations with small for gestational age and sex (SGA) and fetal growth restriction, defined as proportion of optimal birth weight (POBW) below the 10th percentile. Sub-populations investigated were: women who spent most time at home, women who did not move house, women with respiratory or circulatory morbidity, women living in low/middle/high socio-economic areas, women who delivered before 37 weeks gestation, and women who delivered from 37 weeks gestation.
An IQR increase in traffic-related air pollution in the second trimester across all women was associated with an OR of 1.31 (95% CI 1.07 to 1.60) for fetal growth restriction. Effects on fetal growth restriction (low POBW) were highest among women who subsequently delivered before 37 weeks of gestation. Effects on SGA were highest among women who did not move house: OR 1.35 (95% CI 1.08 to 1.69).
Larger effect sizes were observed for low POBW than for SGA. Exposure to traffic-related air pollution in mid to late pregnancy was associated with risk of SGA and low POBW in this study.
胎儿生长受限与母体暴露于高水平交通相关的空气污染之间的关系一直不一致。
我们研究了个体胎儿生长指标与母体接触交通相关空气污染特定标志物之间的关系。
我们使用时间调整的土地利用回归模型来估计 23452 例分娩的孕妇怀孕期间的交通相关空气污染标志物（二氧化氮，NO2）的居住暴露情况。使用逻辑回归调查了与小于胎龄儿（SGA）和胎儿生长受限（定义为低于第 10 百分位数的最佳出生体重（POBW）比例）的关联。研究的亚人群包括：大部分时间待在家里的女性、未搬家的女性、有呼吸道或循环系统疾病的女性、居住在低/中/高社会经济地区的女性、在 37 周妊娠前分娩的女性以及在 37 周妊娠后分娩的女性。
所有女性在第二个三个月中交通相关空气污染增加一个 IQR，与胎儿生长受限的 OR 为 1.31（95%CI 1.07 至 1.60）相关。在随后在 37 周妊娠前分娩的女性中，对胎儿生长受限（低 POBW）的影响最大。在未搬家的女性中，对 SGA 的影响最大：OR 为 1.35（95%CI 1.08 至 1.69）。
低 POBW 的效应大小大于 SGA。在这项研究中，妊娠中期至晚期接触交通相关空气污染与 SGA 和低 POBW 的风险相关。
