DeFranco Emily, Hall Eric, Hossain Monir, Chen Aimin, Haynes Erin N, Jones David, Ren Sheng, Lu Long, Muglia Louis
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America.
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America.
PLoS One. 2015 Mar 20;10(3):e0120594. doi: 10.1371/journal.pone.0120594. eCollection 2015.
To test the hypothesis that exposure to fine particulate air pollution (PM2.5) is associated with stillbirth.
Geo-spatial population-based cohort study using Ohio birth records (2006-2010) and local measures of PM2.5, recorded by the EPA (2005-2010) via 57 monitoring stations across Ohio. Geographic coordinates of the mother's residence for each birth were linked to the nearest PM2.5 monitoring station and monthly exposure averages calculated. The association between stillbirth and increased PM2.5 levels was estimated, with adjustment for maternal age, race, education level, quantity of prenatal care, smoking, and season of conception.
There were 349,188 live births and 1,848 stillbirths of non-anomalous singletons (20-42 weeks) with residence ≤10 km of a monitor station in Ohio during the study period. The mean PM2.5 level in Ohio was 13.3 μg/m3 [±1.8 SD, IQR(Q1: 12.1, Q3: 14.4, IQR: 2.3)], higher than the current EPA standard of 12 μg/m3. High average PM2.5 exposure through pregnancy was not associated with a significant increase in stillbirth risk, adjOR 1.21(95% CI 0.96,1.53), nor was it increased with high exposure in the 1st or 2nd trimester. However, exposure to high levels of PM2.5 in the third trimester of pregnancy was associated with 42% increased stillbirth risk, adjOR 1.42(1.06,1.91).
Exposure to high levels of fine particulate air pollution in the third trimester of pregnancy is associated with increased stillbirth risk. Although the risk increase associated with high PM2.5 levels is modest, the potential impact on overall stillbirth rates could be robust as all pregnant women are potentially at risk.
检验暴露于细颗粒物空气污染（PM2.5）与死产相关的假设。
基于俄亥俄州出生记录（2006 - 2010年）的地理空间人群队列研究，以及美国环境保护局（EPA）（2005 - 2010年）通过俄亥俄州57个监测站记录的当地PM2.5测量数据。每次出生时母亲居住地的地理坐标与最近的PM2.5监测站相关联，并计算每月平均暴露量。估计死产与PM2.5水平升高之间的关联，并对产妇年龄、种族、教育水平、产前护理量、吸烟情况和受孕季节进行调整。
在研究期间，俄亥俄州居住在距离监测站≤10公里处的有349,188例活产和1,848例非异常单胎（20 - 42周）死产。俄亥俄州的PM2.5平均水平为13.3μg/m3 [±1.8标准差，四分位间距（Q1：12.1，Q3：14.4，四分位间距：2.3）]，高于EPA目前12μg/m3的标准。孕期高平均PM2.5暴露与死产风险显著增加无关，校正比值比为1.21（95%置信区间0.96,1.53），在孕早期或孕中期高暴露时也未增加。然而，孕期第三个月暴露于高水平的PM2.5与死产风险增加42%相关，校正比值比为1.42（1.06,1.91）。
孕期第三个月暴露于高水平的细颗粒物空气污染与死产风险增加相关。尽管与高PM2.5水平相关的风险增加幅度不大，但由于所有孕妇都有潜在风险，其对总体死产率的潜在影响可能很大。
