Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Environ Res. 2019 Apr;171:111-118. doi: 10.1016/j.envres.2019.01.031. Epub 2019 Jan 15.
Exposure to particulate matter, particularly with aerodynamic diameter < 2.5 µm (PM), may increase inflammation and oxidative stress in pregnant women and affect fetal growth. We examined trimester specific PM exposure levels and small for gestational age (SGA) using the statewide birth registry of Ohio from 2007 to 2010.
Exposure to PM in each trimester and for each gestational week was determined using data from 57 Environmental Protection Agency network monitoring stations across the state of Ohio. We restricted the data to 224,921 singleton live births, with a gestational age of 20-42 weeks, no genetic disorders or congenital abnormalities, and who had home addresses within a 10 km radius of any PM monitoring station. We estimated odds ratios of SGA using Generalized Linear Models (GLMs) and Distributed Lag Models (DLMs), and adjustment for maternal age, race, education, parity, body mass index, insurance type, tobacco use, prenatal care initiation, birth year, season of birth, and sex of the baby.
Mean PM levels during the entire pregnancy were 13.03 µg/m with a standard deviation of 1.57 µg/m. Covariates adjusted odds ratios and 95% confidence intervals of a 10 µg/m increase in PM levels with a 10 km buffer radius for SGA and trimesters modeled separately were 0.94 (0.88, 1.00) for the first trimester, 0.93 (0.86, 1.00) for the second trimester, 1.07 (1.00, 1.15) for the third trimester, and 0.92 (0.81, 1.06) for the entire pregnancy. When a 5 km buffer radius was used, adjusted odds ratios and 95% confidence intervals for SGA were 0.97 (0.89, 1.05) for the first trimester, 0.96 (0.88, 1.05) for the second trimester, 1.09 (1.02, 1.17) for the third trimester, and 0.99 (0.85, 1.14) for the overall pregnancy, indicating sensitivity to buffer choice. DLMs showed gestational weeks 30-35 to be a particular window of vulnerability.
Increasing exposure to PM during the third trimester of pregnancy was associated with a small increase in risk of SGA in this population-based study. Selection of a buffer radius significantly impacted our results in the first trimester, but not in the third trimester.
暴露于颗粒物，尤其是空气动力学直径 < 2.5 µm（PM）的颗粒物，可能会增加孕妇的炎症和氧化应激，并影响胎儿生长。我们使用俄亥俄州的全州出生登记处 2007 年至 2010 年的数据，检查了孕期特定 PM 暴露水平和小于胎龄儿（SGA）。
使用俄亥俄州 57 个环境保护局网络监测站的数据，确定每个孕期和每一个孕周的 PM 暴露水平。我们将数据限制在 224921 名单胎活产中，这些活产的胎龄为 20-42 周，无遗传疾病或先天性异常，且家庭住址在任何 PM 监测站 10 公里半径范围内。我们使用广义线性模型（GLM）和分布滞后模型（DLM）来估计 SGA 的比值比，并对母亲年龄、种族、教育程度、产次、体重指数、保险类型、吸烟情况、产前护理开始时间、出生年份、出生季节和婴儿性别进行调整。
整个孕期的平均 PM 水平为 13.03 µg/m，标准差为 1.57 µg/m。调整后的比值比和 95%置信区间为，在 10 km 缓冲半径内 PM 水平每增加 10 µg/m，SGA 的比值比为 0.94（0.88，1.00），第一孕期为 0.93（0.86，1.00），第二孕期为 1.07（1.00，1.15），第三孕期为 0.92（0.81，1.06），整个孕期为 0.92（0.81，1.06）。当使用 5 km 缓冲半径时，SGA 的调整比值比和 95%置信区间分别为第一孕期为 0.97（0.89，1.05），第二孕期为 0.96（0.88，1.05），第三孕期为 1.09（1.02，1.17），整个孕期为 0.99（0.85，1.14），表明对缓冲半径的选择具有敏感性。DLM 显示孕 30-35 周是一个特别脆弱的窗口期。
在这项基于人群的研究中，孕妇在孕晚期暴露于 PM 增加与 SGA 风险略有增加有关。缓冲半径的选择对第一孕期的结果有显著影响，但对第三孕期没有影响。
