Orione Maria Angélica M, Silva Clovis A, Sallum Adriana M E, Campos Lúcia M A, Omori Clarissa H, Braga Alfésio L F, Farhat Sylvia C L
Arthritis Care Res (Hoboken). 2014 Oct;66(10):1571-5. doi: 10.1002/acr.22358.
To evaluate the influence of exposure to inhaled environmental factors during pregnancy on the diagnosis of juvenile dermatomyositis (DM).
We performed a case–control study comprising 20 juvenile DM patients and 56 healthy controls matched by age and sex who were residents in the metropolitan region of a large city. A questionnaire assessed demographic data and environmental inhalation exposure during pregnancy (occupational exposure to demolition, chalk, construction and/or quarry dust, paints, varnish, gasoline vapor, and/or battery fluids; stationary sources of inhaled pollution near the mother's home; and maternal tobacco exposure). Daily concentrations of inhaled particulate matter, SO2, NO2, O3, and carbon monoxide (CO) were evaluated throughout the gestational period.
Maternal occupational exposure to school chalk dust/gasoline vapor in the juvenile DM group was significantly higher compared with controls (50% versus 4.6%; P = 0.001). Smoking mothers and secondhand smoke exposure at home during pregnancy were significantly higher in the juvenile DM group versus controls (smoking mothers: 20% versus 1.7%; P = 0.01, and secondhand smoke: 35% versus 19%; P = 0.07). In univariate logistic regression models, maternal smoking, occupational exposure to inhaled agents, and the highest tertile of tropospheric CO (3.2–5.4 parts per million) in the third trimester were significantly associated with juvenile DM (P ≤ 0.05). In the multivariate analysis, smoking mother (odds ratio [OR] 13.26 [95% confidence interval (95% CI) 1.21–144.29], P = 0.03), occupational exposure (OR 35.39 [95% CI 1.97–632.80], P = 0.01), and CO (third tertile) exposure in the third trimester of gestation (OR 12.21 [95% CI 1.28–115.96], P = 0.03) remained risk factors for juvenile DM.
Inhaled pollutants and tobacco smoking during fetal development may contribute to juvenile DM.
评估孕期暴露于吸入性环境因素对青少年皮肌炎（DM）诊断的影响。
我们进行了一项病例对照研究，纳入了20例青少年DM患者和56例按年龄和性别匹配的健康对照，他们均为一个大城市都市区的居民。通过问卷调查评估人口统计学数据以及孕期的环境吸入暴露情况（职业暴露于拆除、粉笔、建筑和/或采石场粉尘、油漆、清漆、汽油蒸汽和/或电池液；母亲家附近的固定吸入污染源；以及母亲的烟草暴露）。在整个孕期评估吸入颗粒物、二氧化硫（SO2）、二氧化氮（NO2）、臭氧（O3）和一氧化碳（CO）的日浓度。
与对照组相比，青少年DM组母亲职业暴露于学校粉笔粉尘/汽油蒸汽的比例显著更高（50% 对 4.6%；P = 0.001）。青少年DM组孕期吸烟的母亲和在家中暴露于二手烟的比例显著高于对照组（吸烟母亲：20% 对 1.7%；P = 0.01，二手烟：35% 对 19%；P = 0.07）。在单因素逻辑回归模型中，母亲吸烟、职业暴露于吸入剂以及孕晚期对流层CO最高三分位数（3.2 - 5.4百万分之一）与青少年DM显著相关（P≤0.05）。在多因素分析中，吸烟母亲（比值比[OR] 13.26 [95%置信区间（95%CI）1.21 - 144.29]，P = 0.03）、职业暴露（OR 35.39 [95%CI 1.97 - 632.80]，P = 0.01）以及孕晚期CO（最高三分位数）暴露（OR 12.21 [95%CI 1.28 - 115.96]，P = 0.03）仍是青少年DM的危险因素。
胎儿发育期间吸入污染物和吸烟可能导致青少年DM。
