From the Department of Public Health Sciences (V.A.-M., J.C.G., P.K.H., T.A.J., K.T.-M., D.Q.R.).
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, PA (V.A.-M.).
Hypertension. 2020 Mar;75(3):851-858. doi: 10.1161/HYPERTENSIONAHA.119.13139. Epub 2020 Jan 6.
Previous studies have reported associations between ambient fine particle concentrations and preeclampsia; however, the impact of particulate pollution on early- and late-onset preeclampsia is understudied. Furthermore, few studies have examined the association between source-specific particles such as markers of traffic pollution or wood combustion on adverse pregnancy outcomes. Electronic medical records and birth certificate data were linked with land-use regression models in Monroe County, New York for 2009 to 2013 to predict monthly pollutant concentrations for each pregnancy until the date of clinical diagnosis during winter (November-April) for 16 116 births. Up to 30% of ambient wintertime fine particle concentrations in Monroe County, New York is from wood combustion. Multivariable logistic regression was used to separately estimate the odds of preeclampsia (all, early-, and late-onset) associated with each interquartile range increase in fine particles, traffic pollution, and woodsmoke concentrations during each gestational month, adjusting for maternal characteristics, birth hospital, temperature, and relative humidity. Each 3.64 µg/m increase in fine particle concentration was associated with an increased odds of early-onset preeclampsia during the first (odds ratio, 1.35 [95% CI, 1.08-1.68]), second (odds ratio, 1.51 [95% CI, 1.23-1.86]), and third (odds ratio, 1.25 [95% CI, 1.06-1.46]) gestational months. Increases in traffic pollution and woodsmoke during the first gestational month were also associated with increased odds of early-onset preeclampsia. Increased odds of late-onset preeclampsia were not observed. Our findings suggest that exposure to wintertime particulate pollution may have the greatest effect on maternal cardiovascular health during early pregnancy.
先前的研究报告表明,环境细颗粒物浓度与子痫前期之间存在关联;然而,关于颗粒物污染对早发和晚发子痫前期的影响研究还很少。此外,很少有研究探讨特定来源的颗粒,如交通污染标志物或木柴燃烧颗粒对不良妊娠结局的影响。电子病历和出生证明数据与纽约州门罗县的土地使用回归模型相链接,用于预测 2009 年至 2013 年期间每个妊娠的每月污染物浓度,直至冬季(11 月至 4 月)期间临床诊断日期,共涉及 16116 例分娩。在纽约州门罗县,高达 30%的冬季环境细颗粒物来自木柴燃烧。多变量逻辑回归用于分别估计每个四分位间距的细颗粒物、交通污染和木柴烟雾浓度增加与子痫前期(所有、早发和晚发)的比值比,在每个妊娠月调整母亲特征、分娩医院、温度和相对湿度。细颗粒物浓度每增加 3.64 µg/m,与早发子痫前期的比值比增加相关,在第一个(比值比,1.35 [95%置信区间,1.08-1.68])、第二个(比值比,1.51 [95%置信区间,1.23-1.86])和第三个(比值比,1.25 [95%置信区间,1.06-1.46])妊娠月。第一个妊娠月交通污染和木柴烟雾的增加也与早发子痫前期的比值比增加相关。未观察到晚发子痫前期比值比增加。我们的研究结果表明,冬季颗粒物污染暴露可能对妊娠早期母亲心血管健康产生最大影响。