General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China.
Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
Environ Res. 2020 Apr;183:109207. doi: 10.1016/j.envres.2020.109207. Epub 2020 Feb 5.
Although studies have assessed the associations of maternal exposure to ozone (O) during pregnancy with blood pressure and the risk of hypertensive disorders of pregnancy (HDP), the results were inconsistent. Furthermore, no studies have been conducted in China where the ambient O concentration continuedly increased. The present study aimed to estimate the effects of maternal exposure to O during pregnancy on the HDP risk, systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP). All participants of pregnant women were selected from the prospective birth cohort study on Prenatal Environments and Offspring Health conducted in Guangzhou, China. A spatiotemporal land-use-regression model was used to estimate individual monthly air pollution exposure from three months before pregnancy to childbirth date. Information on HDP, SBP, DBP and PP was obtained from maternal medical records. A Logistic regression model and a mixed linear model were used to estimate the associations of maternal exposure to O with the risk of HDP and blood pressure (SBP, DBP and PP), respectively. We found significant associations of maternal exposure to O during the third (OR = 1.31, 95%CI: 1.07, 1.60) and the second month (OR = 1.25, 95%CI: 1.02, 1.51) before pregnancy with the risk of HDP. Observed significantly positive associations of O exposures with SBP, DBP and PP during the two months before pregnancy and during the early pregnancy. The peak effects of O exposure on SBP, DBP and PP were respectively observed during the second month of pregnancy (β = 1.07 mmHg, 95%CI: 0.84, 1.31 mmHg), the first month before pregnancy (β = 0.40 mmHg, 95%CI: 0.21, 0.50 mmHg) and the second month of pregnancy (β = 0.78 mmHg, 95%CI: 0.59, 0.97 mmHg). Our results suggest that maternal exposure to O were positively associated with blood pressure and the risk of HDP, and the period from three months before pregnancy to the first trimester might be the critical exposure window.
尽管已有研究评估了孕期母体暴露于臭氧（O）与血压和妊娠高血压疾病（HDP）风险之间的关联，但结果并不一致。此外，在中国，环境臭氧浓度持续升高的情况下，尚未开展相关研究。本研究旨在评估孕期母体暴露于 O 对 HDP 风险、收缩压（SBP）、舒张压（DBP）和脉压（PP）的影响。所有孕妇参与者均选自在中国广州开展的“产前环境与后代健康”前瞻性出生队列研究。采用时空土地利用回归模型来估算自妊娠前三个月至分娩日期个体每月的空气污染暴露情况。HDP、SBP、DBP 和 PP 相关信息来自产妇病历。采用 Logistic 回归模型和混合线性模型分别来评估母体暴露于 O 与 HDP 风险和血压（SBP、DBP 和 PP）之间的关联。结果发现，孕期第三个月（OR=1.31，95%CI：1.07，1.60）和第二个月（OR=1.25，95%CI：1.02，1.51）暴露于 O 与 HDP 风险显著相关。在妊娠前两个月和妊娠早期观察到 O 暴露与 SBP、DBP 和 PP 呈显著正相关。O 暴露对 SBP、DBP 和 PP 的最大影响分别发生在妊娠第二个月（β=1.07mmHg，95%CI：0.84，1.31mmHg）、妊娠前一个月（β=0.40mmHg，95%CI：0.21，0.50mmHg）和妊娠第二个月（β=0.78mmHg，95%CI：0.59，0.97mmHg）。结果提示，母体暴露于 O 与血压和 HDP 风险呈正相关，妊娠前三个月至妊娠早期可能是关键的暴露窗口期。
