Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, PR China.
Environ Res. 2019 Jun;173:366-372. doi: 10.1016/j.envres.2019.03.056. Epub 2019 Mar 26.
Fetal essential organ development is completed during early pregnancy which is important for fetal and postnatal health. However, the effect of exposure to PM on fetal growth during early pregnancy is less studied and the related mechanisms are largely unknown.
We conducted a birth cohort study of 1945 pregnant women with measurement of the fetal crown to rump length (CRL) by ultrasound between the gestational age of 11 and 14 weeks. We estimated residential exposures of PM from the date of LMP to the date of ultrasound examination using a spatial-temporal land use regression model. Maternal hemoglobin concentration was examined by maternal blood samples during the same gestational period or ±1 week of the ultrasound examination. The associations of exposure to PM with maternal hemoglobin concentration, and exposure to PM with fetal CRL during early pregnancy were estimated by multiple linear regression models. The mediation effect of maternal hemoglobin concentration on the association between exposure to PM and fetal CRL was explored by a casual mediation analysis.
One IQR increment of prenatal exposure to PM was associated with a 0.929 g/L (95% CI: 0.068, 1.789) increase in maternal hemoglobin concentration, and associated with a -0.082 cm (95% CI: 0.139, -0.025) decrease in fetal CRL. One g/L increment of maternal hemoglobin concentration was associated a -0.011 cm (95% CI: 0.014, -0.008) decrease in fetal CRL. The mediation analysis indicated that 12.1% of the total effect of prenatal exposure to PM on reducing fetal CRL was mediated by increased maternal hemoglobin concentration.
Exposure to PM was associated with reduced fetal growth during early pregnancy and elevated maternal hemoglobin concentration mediated this association.
胎儿的重要器官在妊娠早期发育完成，这对胎儿和产后健康都很重要。然而，暴露于 PM 对妊娠早期胎儿生长的影响研究较少，相关机制也知之甚少。
我们对 1945 名孕妇进行了一项出生队列研究，在妊娠 11 至 14 周时通过超声测量胎儿头臀长（CRL）。我们使用时空土地利用回归模型，根据末次月经日期到超声检查日期估计 PM 的住宅暴露量。在同一妊娠期间或超声检查前后±1 周，通过母亲血液样本检测母体血红蛋白浓度。采用多元线性回归模型估计 PM 暴露与妊娠早期母体血红蛋白浓度以及 PM 暴露与胎儿 CRL 之间的关系。采用因果中介分析探讨母体血红蛋白浓度对 PM 暴露与胎儿 CRL 之间关联的中介效应。
产前 PM 暴露每增加一个 IQR，母体血红蛋白浓度增加 0.929g/L（95%CI：0.068，1.789），胎儿 CRL 减少 0.082cm（95%CI：0.139，-0.025）。母体血红蛋白浓度每增加 1g/L，胎儿 CRL 减少 0.011cm（95%CI：0.014，-0.008）。中介分析表明，产前 PM 暴露对降低胎儿 CRL 的总效应有 12.1%是通过增加母体血红蛋白浓度来介导的。
暴露于 PM 与妊娠早期胎儿生长减少有关，而母体血红蛋白浓度的升高介导了这种关联。
