Ji Yinwen, Song Fei, Xu Bo, Zhu Yining, Lu Chuncheng, Xia Yankai
State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, Jiangsu 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; Department of Research and Education, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China.
J Biomed Res. 2017 Nov 1;33(1):56-68. doi: 10.7555/JBR.31.20170038.
Studies of the associations between maternal exposure to particulate matter (PM) and risk of adverse effects on fetal growth are inconsistent and inconclusive. This question can be well answered by carefully designed birth cohort studies; however, so far the evidence from such studies has not come to the same conclusion. We sought to evaluate the association between maternal exposures to PM and low birthweight (LBW) enrolling 14 studies from 11 centers, and to explore the influence of trimester and exposure assessment methods on between-center heterogeneity in this association. Data were derived from PubMed, Embase, Google Scholar, CNKI, and WanFang database, references from relevant articles, and results from published studies until March 2017. Using a random-effects meta-analysis, we combined the coefficient and odds ratios (OR) of individual studies conducted among 14 birth cohort studies. Random-effect meta-analysis results suggested that a 17% and 6% increase in risk of LBW was relevant to a 10 mg/m rise in PM and PM exposure concentrations at the 3rd trimester (pooled odds ratios (OR), 1.17 and 1.06; 95% confidence interval (CI), 0.94-1.46 and 0.97-1.15, respectively), but the null value was included in our 95% CI. Our results showed that exposure to PM and PM during pregnancy has a positive relevance to LBW based on birth cohort studies. However, neither reached formal statistical significance. Negative impacts on outcomes of birth is implied by maternal exposure to PM. Further mechanistic researches are needed to explain the connection between PM pollution and LBW.
关于母亲暴露于颗粒物（PM）与胎儿生长不良风险之间关联的研究结果并不一致且尚无定论。精心设计的出生队列研究能够很好地回答这个问题；然而，迄今为止此类研究的证据尚未得出相同结论。我们纳入了来自11个中心的14项研究，旨在评估母亲暴露于PM与低出生体重（LBW）之间的关联，并探讨孕期和暴露评估方法对该关联中心间异质性的影响。数据来源于PubMed、Embase、谷歌学术、中国知网和万方数据库、相关文章的参考文献以及截至2017年3月已发表研究的结果。我们采用随机效应荟萃分析，合并了14项出生队列研究中各项研究的系数和比值比（OR）。随机效应荟萃分析结果表明，孕晚期PM和PM暴露浓度每升高10 mg/m³，LBW风险分别增加17%和6%（合并比值比（OR）分别为1.17和1.06；95%置信区间（CI）分别为0.94 - 1.46和0.97 - 1.15），但我们的95% CI包含了无效值。我们的结果表明，基于出生队列研究，孕期暴露于PM和PM与LBW呈正相关。然而，两者均未达到正式的统计学显著性。母亲暴露于PM意味着对出生结局有负面影响。需要进一步的机制研究来解释PM污染与LBW之间的联系。
