SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India.
SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India.
Environ Res. 2018 Feb;161:524-531. doi: 10.1016/j.envres.2017.11.050.
Exposure to PM (fine particulate matter <less than 2.5µm in aerodynamic diameter) related to ambient and household air pollution has been associated with low birthweight. Few of these studies, however, have been conducted in high exposure settings that are commonly encountered in low and middle income countries (LMICs).
We examined whether PM exposures during pregnancy were associated with birthweight in an integrated rural-urban, mother-child cohort in the state of Tamil Nadu, India.
We recruited 1285 pregnant women in the first trimester of pregnancy from primary health care centers and urban health posts and followed them until birth to collect antenatal care data and birthweight. We estimated pregnancy period PM exposures through direct serial measurements of 24-h household PM concentrations, performed across each trimester. Mothers also completed detailed questionnaires to provide data on covariates related to household, socio-economic, demographic and maternal health characteristics. The association between PM exposures and birth weight was assessed using linear and logistic regression models that controlled for potential confounders.
A 10-μg/m increase in pregnancy period PM exposures was associated with a 4g (95% CI: 1.08g, 6.76g) decrease in birthweight and 2% increase in prevalence of low birthweight [odds ratio(OR) = 1.02; 95%CI:1.005,1.041] after adjusting for gestational age, infant sex, maternal BMI, maternal age, history of a previous low birth weight child, birth order and season of conception.
The study provides some of the first quantitative effects estimates for linking rural-urban PM exposures and birthweight in India, adding important evidence for this association from high exposure settings in LMICs, that also experience dual health burdens from ambient and household air pollution. Study results also point to the need for considering maternal PM exposures alongside other risk factors for low birthweight in India.
暴露于 PM（空气动力学直径小于 2.5μm 的细颗粒物）与环境和家庭空气污染有关，与低出生体重有关。然而，这些研究中很少有在高暴露环境中进行的，而高暴露环境在中低收入国家（LMICs）中很常见。
我们在印度泰米尔纳德邦的一个城乡一体化母婴队列中，研究了孕期 PM 暴露与出生体重的关系。
我们在妊娠早期从初级保健中心和城市健康站招募了 1285 名孕妇，并在整个孕期内跟踪她们，以收集产前保健数据和出生体重。我们通过在每个孕期直接连续测量 24 小时家庭 PM 浓度来估计孕期 PM 暴露。母亲还完成了详细的问卷，提供了与家庭、社会经济、人口统计学和母亲健康特征相关的协变量数据。使用线性和逻辑回归模型评估 PM 暴露与出生体重之间的关系，该模型控制了潜在的混杂因素。
孕期 PM 暴露增加 10μg/m，与出生体重下降 4g（95%置信区间：1.08g，6.76g）和低出生体重发生率增加 2%相关[比值比（OR）=1.02；95%置信区间：1.005，1.041]，调整了胎龄、婴儿性别、母亲 BMI、母亲年龄、既往低出生体重儿史、出生顺序和受孕季节后。
该研究提供了一些将城乡 PM 暴露与印度出生体重联系起来的首批定量效应估计值，为中低收入国家高暴露环境中存在这种关联提供了重要证据，这些国家也同时面临着环境和家庭空气污染带来的双重健康负担。研究结果还表明，在印度，需要考虑 PM 暴露与其他低出生体重风险因素一起，作为低出生体重的风险因素。
