University of Montreal Hospital Research Centre, 900 Saint Denis St., Montreal, Quebec, H2X 0A9, Canada; Institut national de santé publique du Québec, 190 Cremazie Blvd E, Montreal, Quebec, H2P 1E2, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada.
Institut national de santé publique du Québec, 190 Cremazie Blvd E, Montreal, Quebec, H2P 1E2, Canada; Faculty of Pharmacy, University of Clermont-Auvergne, 28 Place Henri-Dunant BP 38, Clermont-Ferrand, 63001, France.
Environ Pollut. 2018 Aug;239:599-606. doi: 10.1016/j.envpol.2018.04.060. Epub 2018 Apr 25.
Environmental noise exposure is associated with a greater risk of hypertension, but the link with preeclampsia, a hypertensive disorder of pregnancy, is unclear.
We sought to determine the relationship between environmental noise pollution and risk of preeclampsia during pregnancy.
We analyzed a population-based cohort comprising 269,263 deliveries on the island of Montreal, Canada between 2000 and 2013. We obtained total environmental noise pollution measurements (LA, L, L) from land use regression models, and assigned noise levels to each woman based on the residential postal code. We computed odds ratios (OR) and 95% confidence intervals (CI) for the association of noise with preeclampsia in mixed logistic regression models with participants as a random effect, and adjusted for air pollution, neighbourhood walkability, maternal age, parity, multiple pregnancy, comorbidity, socioeconomic deprivation, and year of delivery. We assessed whether noise exposure was more strongly associated with severe or early onset preeclampsia than mild or late onset preeclampsia.
Prevalence of preeclampsia was higher for women exposed to elevated environmental noise pollution levels (LA ≥ 65 dB(A) = 37.9 per 1000 vs. <50 dB(A) = 27.9 per 1000). Compared with 50 dB(A), an LA of 65.0 dB(A) was not significantly associated the risk of preeclampsia (OR 1.09, 95% CI 0.99-1.20). Associations were however present with severe (OR 1.29, 95% CI 1.09-1.54) and early onset (OR 1.71, 95% CI 1.20-2.43) preeclampsia, with results consistent across all noise indicators. The associations were much weaker or absent for mild and late preeclampsia.
Environmental noise pollution may be a novel risk factor for pregnancy-related hypertension, particularly more severe variants of preeclampsia.
环境噪声暴露与高血压风险增加有关,但与妊娠高血压疾病子痫前期之间的关系尚不清楚。
我们旨在确定环境噪声污染与妊娠期间子痫前期风险之间的关系。
我们分析了一个基于人群的队列,该队列包含 2000 年至 2013 年期间在加拿大蒙特利尔岛上的 269263 例分娩。我们从土地利用回归模型中获得了总环境噪声污染测量值(LA、L、L),并根据女性的居住邮政编码为每位女性分配噪声水平。我们在混合逻辑回归模型中使用参与者作为随机效应,调整了空气污染、邻里可达性、母亲年龄、产次、多胎妊娠、合并症、社会经济剥夺和分娩年份,计算了噪声与子痫前期之间的比值比(OR)和 95%置信区间(CI)。我们评估了噪声暴露是否与严重或早发型子痫前期的关联强于轻度或晚发型子痫前期。
暴露于环境噪声污染水平升高的女性(LA≥65dB(A)为 37.9/1000 例,<50dB(A)为 27.9/1000 例)子痫前期的患病率更高。与 50dB(A)相比,LA 为 65.0dB(A)与子痫前期的风险无显著关联(OR 1.09,95%CI 0.99-1.20)。然而,与严重(OR 1.29,95%CI 1.09-1.54)和早发(OR 1.71,95%CI 1.20-2.43)子痫前期相关,所有噪声指标的结果均一致。对于轻度和晚发型子痫前期,相关性较弱或不存在。
环境噪声污染可能是妊娠相关高血压的一个新的危险因素,特别是更严重的子痫前期。