From the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (M.Z., N.T.M., L.J.A.).
Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (M.Z., N.T.M., L.J.A.).
Hypertension. 2018 Jul;72(1):194-201. doi: 10.1161/HYPERTENSIONAHA.117.10944. Epub 2018 May 14.
Exposure to ambient air pollution has been associated with greater risk of elevated blood pressure (BP) in adults and children. Recent evidence suggests that air pollution exposure in pregnancy may also portend increased risk for the next generation; however, few studies have examined this relationship. We conducted a prospective study of 1293 mothers in the Boston Birth Cohort (enrolled 1998-2012) and their children who had follow-up visits between 3 and 9 years of age and complete exposure and outcome data. Our primary exposure, ambient particulate matter ≤2.5 µm (PM) concentration during pregnancy, was estimated by matching mother's residential address to the US Environmental Protection Agency's air quality monitors. We defined our primary outcome child systolic BP (SBP) percentile according to US reference (Fourth Report) and classified elevated BP as SBP ≥90th percentile. Our multivariable-adjusted cubic spline showed a sharp increase in offspring SBP percentile and risk for elevated BP when third-trimester PM concentration was ≥13 μg/m The highest versus lowest tertile of third-trimester PM exposure was associated with a 4.85 (95% confidence interval: 1.38-8.37) percentile increase in child SBP or a 1.61 (95% confidence interval: 1.13-2.30) times higher risk of child elevated BP. A 5-μg/m increment in PM during the third trimester was associated with a 3.49 (95% confidence interval: 0.71-6.26) percentile increase in child SBP or a 1.47 (95% confidence interval: 1.17-1.85) times higher risk of elevated BP. Our findings suggest that exposure to ambient PM during the third trimester of pregnancy is associated with elevated BP in children, ages 3 to 9 years.
暴露于环境空气中的污染物与成人和儿童血压升高的风险增加有关。最近的证据表明，妊娠期间接触空气污染也可能预示着下一代的风险增加；然而，很少有研究检查过这种关系。我们对 1293 名母亲进行了一项前瞻性研究，这些母亲参加了波士顿出生队列（1998-2012 年注册），她们的孩子在 3 至 9 岁时进行了随访，并完成了暴露和结果数据。我们的主要暴露是母亲怀孕期间环境中 2.5μm 以下的颗粒物（PM）浓度，通过将母亲的居住地址与美国环境保护署的空气质量监测器相匹配来估计。我们根据美国参考资料（第四报告）定义了我们的主要结果儿童收缩压（SBP）百分位数，并将高血压定义为 SBP≥90 百分位数。我们的多元调整三次样条显示，当第三孕期 PM 浓度≥13μg/m 时，后代 SBP 百分位数和高血压风险急剧增加。第三孕期 PM 暴露最高与最低三分位数相比，儿童 SBP 增加 4.85（95%置信区间：1.38-8.37）个百分位数，儿童高血压的风险增加 1.61（95%置信区间：1.13-2.30）倍。第三孕期 PM 增加 5μg/m，儿童 SBP 增加 3.49（95%置信区间：0.71-6.26）个百分位数，儿童高血压的风险增加 1.47（95%置信区间：1.17-1.85）倍。我们的研究结果表明，妊娠晚期暴露于环境 PM 与 3 至 9 岁儿童的血压升高有关。
