Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050, China.
Yale University School of Public Health, 60 College Street, New Haven, CT 06510, USA.
Health Place. 2018 Sep;53:258-263. doi: 10.1016/j.healthplace.2018.08.021. Epub 2018 Sep 6.
Studies on environmental exposures during pregnancy commonly use maternal residence at time of delivery, which may result in exposure misclassification and biased estimates of exposure and disease association. Studies on residential mobility during pregnancy are needed in various populations to aid studies of the environmental exposure and birth outcomes. However, there is still a lack of studies investigating residential mobility patterns in Asian populations.
We analyzed data from 10,542 pregnant women enrolled in a birth cohort study in Lanzhou, China (2010-2012), a major industrial city. Multivariate logistic regression was used to evaluate residential mobility patterns in relation to maternal complications and birth outcomes.
Of the participants, 546 (5.2%) moved during pregnancy; among those who moved, 40.5%, 34.8%, and 24.7% moved during the first, second, and third trimester, respectively. Most movers (97.3%) moved once with a mean distance of 3.75 km (range: 1-109 km). More than half (66.1%) of the movers moved within 3 km, 13.9% moved 3-10 km, and 20.0% moved > 10 km. Pregnant women who were > 30 years or multiparous, or who had maternal complications were less likely to have moved during pregnancy. In addition, movers were less likely to deliver infants with birth defects, preterm births, and low birth weight.
Residential mobility was significantly associated with several maternal characteristics and complications during pregnancy. The study also showed a lower likelihood of adverse birth outcomes among movers than non-movers, suggesting that moving might be related to reduce exposure to environmental hazards. These results confirm the hypothesis that residential mobility may be important with respect to exposure misclassification and that this misclassification may vary by subpopulations.
在研究孕期环境暴露时,通常采用分娩时母亲的居住地,这可能导致暴露错误分类和对暴露与疾病关联的有偏估计。需要在不同人群中开展关于孕期居住地变化的研究,以辅助进行环境暴露与出生结局的研究。然而,目前仍缺乏对亚洲人群居住地变化模式的研究。
我们分析了中国兰州一项出生队列研究(2010-2012 年)中 10542 名孕妇的数据,兰州是一个主要的工业城市。采用多变量逻辑回归分析居住地变化模式与产妇并发症和出生结局的关系。
研究参与者中,546 人(5.2%)在孕期搬家;其中,40.5%、34.8%和 24.7%分别在孕早期、孕中期和孕晚期搬家。大多数(97.3%)的搬家者只搬过一次,平均距离为 3.75 公里(范围:1-109 公里)。超过一半(66.1%)的搬家者在 3 公里以内,13.9%的搬家者在 3-10 公里之间,20.0%的搬家者搬家距离>10 公里。年龄>30 岁或多产妇,或有产妇并发症的孕妇在孕期搬家的可能性较小。此外,搬家者的婴儿出生缺陷、早产和低出生体重的发生率较低。
居住地变化与孕期的一些产妇特征和并发症显著相关。研究还表明,搬家者的不良出生结局发生的可能性低于非搬家者,这表明搬家可能与减少接触环境危害有关。这些结果证实了这样一种假设,即居住地变化可能与暴露错误分类有关,而且这种错误分类可能因亚人群而异。