Cheng Yanpeng, Feng Yongliang, Duan Xiaoli, Zhao Nan, Wang Jun, Li Chunxia, Guo Pengge, Xie Bingjie, Zhang Fang, Wen Haixiu, Li Mei, Wang Ying, Wang Suping, Zhang Yawei
Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China.
State Key Lab of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Apr;37(4):572-7. doi: 10.3760/cma.j.issn.0254-6450.2016.04.027.
To investigate the association between ambient fine particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) and the risk on preterm birth.
A total of 1 882 pregnant women with local residency of Taiyuan city and underwent delivery at the First Hospital of Shanxi Medical University with the dates of conception between January 1 and December 31, 2013, were enrolled in the study. Information on general demographics, home address and history on pregnancy, lifestyle and related environmental factors were collected through in-person interview. Birth outcomes and maternal complications were abstracted from medical records. Data on the amount of daily average PM2.5 from 8 monitor points in Taiyuan city, between March 1, 2012 and December 31, 2013 were also collected. Individual exposure during pregnancy were calculated using the inverse-distance weighting method, based on home address. Multivariate unconditional logistic regression model was used to examine the associations among PM2.5 exposure, risk of preterm birth and related clinical subtypes.
The overall incidence of preterm birth was 8.21% (151/1 839)in 1 839 pregnant women. Exposure to ambient PM2.5 during the second week prior to delivery was associated with an increased risk of preterm birth (OR=1.087, 95% CI: 1.001-1.182 per 10 μg/m(3) increase) and mild preterm birth (OR=1.099, 95% CI: 1.007-1.200 per 10 μg/m(3)). Compared to data from the China Environmental Air Quality Standard, higher level of exposure (≥75 μg/m(3)) of PM2.5 during the second week before delivery was associated with an increased risk of preterm birth (OR=1.008, 95%CI: 1.000-1.017) but the association was mainly seen for mild preterm birth (OR=1.010, 95%CI: 1.001-1.018).
RESULTS from our study showed that exposure to high level of PM2.5 during late pregnancy would increase the risk of preterm birth. Future large studies are needed to examine the association by preterm clinical subtypes and to elucidate potential underlying mechanisms.
探讨空气动力学直径小于2.5μm的环境细颗粒物(PM2.5)与早产风险之间的关联。
本研究纳入了1882名具有太原市本地户籍、于2013年1月1日至12月31日期间在山西医科大学第一医院分娩的孕妇。通过面对面访谈收集了一般人口统计学信息、家庭住址、妊娠史、生活方式及相关环境因素等信息。从医疗记录中提取出生结局和孕产妇并发症信息。还收集了2012年3月1日至2013年12月31日期间太原市8个监测点的每日平均PM2.5量数据。根据家庭住址,采用反距离加权法计算孕期个体暴露量。采用多变量无条件逻辑回归模型检验PM2.5暴露、早产风险及相关临床亚型之间的关联。
1839名孕妇的早产总发生率为8.21%(151/1839)。分娩前第二周暴露于环境PM2.5与早产风险增加相关(每增加10μg/m³,OR=1.087,95%CI:1.001-1.182)以及轻度早产相关(每增加10μg/m³,OR=1.099,95%CI:1.007-1.200)。与中国环境空气质量标准数据相比,分娩前第二周PM2.5暴露水平较高(≥75μg/m³)与早产风险增加相关(OR=1.008,95%CI:1.000-1.017),但这种关联主要见于轻度早产(OR=1.010,95%CI:1.001-1.018)。
我们的研究结果表明,妊娠晚期暴露于高水平的PM2.5会增加早产风险。未来需要进行大规模研究,以按早产临床亚型研究这种关联并阐明潜在的潜在机制。