Pereira Gavin, Bracken Michael B, Bell Michelle L
School of Public Health, Curtin University, Perth, WA 6845, Australia.
Center for Perinatal Pediatric and Environmental Epidemiology, School of Medicine, Yale University, New Haven, CT 06511, USA.
Environ Res. 2016 May;147:269-74. doi: 10.1016/j.envres.2016.02.001. Epub 2016 Feb 23.
It remains unclear as to whether neglecting residential mobility during pregnancy introduces bias in studies investigating air pollution and adverse perinatal outcomes, as most studies assess exposure based on residence at birth. The aim of this study was to ascertain whether such bias can be observed in a study on the effects of PM10 on risk of preterm birth and fetal growth restriction.
This was a retrospective study using four pregnancy cohorts of women recruited in Connecticut, USA (N=10,025). We ascertained associations with PM10 exposure calculated using first recorded maternal address, last recorded address, and full address histories. We used a discrete time-to-event model for preterm birth, and logistic regression to investigate associations with small for gestational age (SGA) and term low birth weight (LBW).
Pregnant women tended to move to areas with lower levels of PM10. For all outcomes, there was negligible difference between effect sizes corresponding to exposures calculated with first, last and full address histories. For LBW, associations were observed for exposure in second trimester (OR 1.09; 95% CI: 1.04-1.14 per 1μg/m(3) PM10) and whole pregnancy (OR 1.08; 95% CI: 1.02-1.14). For SGA, associations were observed for elevated exposure in second trimester (OR 1.02; 95% CI: 1.00-1.04) and whole pregnancy (OR 1.03; 95% CI: 1.01-1.05). There was insufficient evidence for association with preterm birth.
PM10 was associated with both SGA and term LBW. However, there was negligible benefit in accounting for residential mobility in pregnancy in this study.
孕期忽视居住流动性是否会在空气污染与不良围产期结局的研究中引入偏差尚不清楚,因为大多数研究是根据出生时的居住地来评估暴露情况的。本研究的目的是确定在一项关于PM10对早产风险和胎儿生长受限影响的研究中是否能观察到这种偏差。
这是一项回顾性研究,使用了在美国康涅狄格州招募的四个孕妇队列(N = 10,025)。我们确定了与使用首次记录的母亲住址、末次记录的住址以及完整住址历史计算出的PM10暴露之间的关联。我们使用离散时间事件模型来分析早产情况,并使用逻辑回归来研究与小于胎龄儿(SGA)和足月低出生体重(LBW)之间的关联。
孕妇倾向于搬到PM10水平较低的地区。对于所有结局,使用首次、末次和完整住址历史计算出的暴露对应的效应大小之间差异可忽略不计。对于LBW,在孕中期暴露(每1μg/m³ PM10的OR为1.09;95% CI:1.04 - 1.14)和整个孕期暴露(OR为1.08;95% CI:1.02 - 1.14)中观察到关联。对于SGA,在孕中期暴露升高(OR为1.02;95% CI:1.00 - 1.04)和整个孕期暴露(OR为1.03;95% CI:1.01 - 1.05)中观察到关联。没有足够证据表明与早产有关联。
PM10与SGA和足月LBW均有关联。然而,在本研究中考虑孕期居住流动性的益处可忽略不计。