Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Environ Health Perspect. 2013 Nov-Dec;121(11-12):1365-71. doi: 10.1289/ehp.1206430. Epub 2013 Sep 10.
Available evidence concerning the association between air pollution and preeclampsia is limited, and specific associations with early- and late-onset preeclampsia have not been assessed.
We investigated the association, if any, between preeclampsia (all, early-, and late-onset) and exposure to nitrogen dioxide, nitrogen oxides, particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5; fine particles), ≤ 10 μm, and 2.5-10 μm, and PM2.5 light absorption (a proxy for elemental carbon) during the entire pregnancy and during the first, second, and third trimesters.
This study was based on 8,398 pregnancies (including 103 cases of preeclampsia) among women residing in Barcelona, Spain (2000-2005). We applied a spatiotemporal exposure assessment framework using land use regression models to predict ambient pollutant levels during each week of pregnancy at the geocoded residence address of each woman at the time of birth. Logistic and conditional logistic regression models were used to estimate unadjusted and adjusted associations.
We found positive associations for most of our evaluated outcome-exposure pairs, with the strongest associations observed for preeclampsia and late-onset preeclampsia in relation to the third-trimester exposure to fine particulate pollutants, and for early-onset preeclampsia in relation to the first-trimester exposure to fine particulate pollutants. Among our investigated associations, those of first- and third-trimester exposures to PM2.5 and third-trimester exposure to PM2.5 absorbance and all preeclampsia, and third-trimester PM2.5 exposure and late-onset preeclampsia attained statistical significance.
We observed increased risk of preeclampsia associated with exposure to fine particulate air pollution. Our findings, in combination with previous evidence suggesting distinct pathogenic mechanisms for early- and late-onset preeclampsia, support additional research on this topic.
有关空气污染与子痫前期之间关联的现有证据有限，并且尚未评估特定的与早发型和晚发型子痫前期的关联。
我们研究了子痫前期（所有、早发型和晚发型）与二氧化氮、氮氧化物、空气动力学直径≤2.5μm（细颗粒物）、≤10μm 和 2.5-10μm 颗粒物以及 PM2.5 光吸收（元素碳的代理）暴露之间的任何关联在整个怀孕期间以及在第一、第二和第三孕期。
本研究基于居住在西班牙巴塞罗那的 8398 名孕妇（包括 103 例子痫前期）（2000-2005 年）。我们应用时空暴露评估框架，使用土地利用回归模型预测每个孕妇出生时所在地的每个孕周的环境污染物水平。我们使用逻辑斯蒂和条件逻辑斯蒂回归模型来估计未调整和调整后的关联。
我们发现对于我们评估的大多数结果-暴露对，都存在阳性关联，与第三孕期细颗粒物污染物暴露相关的子痫前期和晚发型子痫前期以及与第一孕期细颗粒物污染物暴露相关的早发型子痫前期的关联最强。在我们研究的关联中，第一和第三孕期暴露于 PM2.5 和第三孕期暴露于 PM2.5 吸光度以及所有子痫前期，以及第三孕期 PM2.5 暴露与晚发型子痫前期的关联具有统计学意义。
我们观察到与细颗粒物空气污染暴露相关的子痫前期风险增加。我们的研究结果结合先前表明早发型和晚发型子痫前期具有不同发病机制的证据，支持对此主题进行更多研究。
