Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Environ Health Perspect. 2013 Mar;121(3):267-373. doi: 10.1289/ehp.1205575. Epub 2013 Feb 6.
A growing body of evidence has associated maternal exposure to air pollution with adverse effects on fetal growth; however, the existing literature is inconsistent.
We aimed to quantify the association between maternal exposure to particulate air pollution and term birth weight and low birth weight (LBW) across 14 centers from 9 countries, and to explore the influence of site characteristics and exposure assessment methods on between-center heterogeneity in this association.
Using a common analytical protocol, International Collaboration on Air Pollution and Pregnancy Outcomes (ICAPPO) centers generated effect estimates for term LBW and continuous birth weight associated with PM(10) and PM(2.5) (particulate matter ≤ 10 and 2.5 µm). We used meta-analysis to combine the estimates of effect across centers (~ 3 million births) and used meta-regression to evaluate the influence of center characteristics and exposure assessment methods on between-center heterogeneity in reported effect estimates.
In random-effects meta-analyses, term LBW was positively associated with a 10-μg/m3 increase in PM10 [odds ratio (OR) = 1.03; 95% CI: 1.01, 1.05] and PM(2.5) (OR = 1.10; 95% CI: 1.03, 1.18) exposure during the entire pregnancy, adjusted for maternal socioeconomic status. A 10-μg/m3 increase in PM(10) exposure was also negatively associated with term birth weight as a continuous outcome in the fully adjusted random-effects meta-analyses (-8.9 g; 95% CI: -13.2, -4.6 g). Meta-regressions revealed that centers with higher median PM(2.5) levels and PM(2.5):PM(10) ratios, and centers that used a temporal exposure assessment (compared with spatiotemporal), tended to report stronger associations.
Maternal exposure to particulate pollution was associated with LBW at term across study populations. We detected three site characteristics and aspects of exposure assessment methodology that appeared to contribute to the variation in associations reported by centers.
越来越多的证据表明，母亲暴露于空气污染与胎儿生长不良有关; 然而，现有的文献并不一致。
我们旨在量化 9 个国家 14 个中心的母亲暴露于颗粒物空气污染与足月出生体重和低出生体重（LBW）之间的关联，并探讨该关联的中心间异质性与地点特征和暴露评估方法的关系。
使用共同的分析方案，国际空气污染与妊娠结局合作研究（ICAPPO）中心为 PM（10）和 PM（2.5）（颗粒物≤10 和 2.5 µm）与足月 LBW 和连续出生体重相关的效应估计值。我们使用荟萃分析合并中心间的效应估计值（约 300 万例出生），并使用荟萃回归评估中心特征和暴露评估方法对报告的效应估计值的中心间异质性的影响。
在随机效应荟萃分析中，调整母亲社会经济状况后，整个孕期 PM10 每增加 10μg/m3，足月 LBW 的比值比（OR）为 1.03（95%置信区间：1.01, 1.05），PM（2.5）为 1.10（95%置信区间：1.03, 1.18）。PM（10）暴露量每增加 10μg/m3，也与完全调整后的随机效应荟萃分析中的连续出生体重呈负相关（-8.9g；95%置信区间：-13.2，-4.6g）。元回归表明，PM（2.5）水平和 PM（2.5）：PM（10）比值中位数较高的中心以及使用时间暴露评估（与时空相比）的中心，报告的关联更强。
在研究人群中，母亲暴露于颗粒物污染与足月 LBW 有关。我们发现有三个地点特征和暴露评估方法的方面似乎导致了中心报告的关联存在差异。
