Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
Environ Res. 2020 Aug;187:109643. doi: 10.1016/j.envres.2020.109643. Epub 2020 May 11.
The number of studies on air pollution with birth defects as the primary outcome has increased dramatically over the past two decades, but the potential role of specific air pollutants in congenital limb anomalies remains unclear.
To evaluate associations between preconception and first-trimester PM exposure and polydactyly and syndactyly in a population-based case-control study.
Polydactyly cases (n = 2605), syndactyly cases (n = 595), and controls without any birth defects (n = 7950) born between 2010 and 2015 were selected from the Maternal and Child Health Certificate Registry of Liaoning Province. The monthly mean PM concentrations were obtained from 75 air monitoring stations, and the exposure assessment was based on the mean concentration of all stations in mother's residential city. A multivariable logistic regression model was constructed to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
PM exposure was positively associated with the risks of polydactyly (preconception: aOR = 1.95, 95% CI 1.56-2.45, aOR = 1.06, 95% CI 1.01-1.10 [per 10-μg/m increment]; first-trimester: aOR = 2.51, 95% CI 2.00-3.15) and syndactyly (preconception: aOR = 2.86, 95% CI 1.98-4.13, aOR = 1.11, 95% CI 1.03-1.20 [per 10-μg/m increment]; first-trimester: aOR = 3.10, 95% CI 2.11-4.56). Analyses based on single month exposure windows basically showed similar positive associations. Additionally, these findings were robust in sensitivity analyses and broadly consistent across subgroups.
Our study suggest that preconception and first-trimester PM exposures are related to increased risks of polydactyly and syndactyly.
在过去的二十年中，以出生缺陷为主要结局的空气污染研究数量急剧增加，但特定空气污染物在先天性肢体畸形中的潜在作用仍不清楚。
在一项基于人群的病例对照研究中，评估孕前和孕早期 PM 暴露与多指畸形和并指畸形之间的关系。
选择 2010 年至 2015 年期间在辽宁省母婴健康证书登记处登记的 2605 例多指畸形病例、595 例并指畸形病例和 7950 例无出生缺陷对照。从 75 个空气质量监测站获得每月平均 PM 浓度，暴露评估基于母亲居住城市所有站点的平均浓度。采用多变量逻辑回归模型计算调整后的比值比 (aOR) 和 95%置信区间 (CI)。
PM 暴露与多指畸形的风险呈正相关（孕前：aOR=1.95，95%CI 1.56-2.45，aOR=1.06，95%CI 1.01-1.10[每 10μg/m 增加]；孕早期：aOR=2.51，95%CI 2.00-3.15）和并指畸形（孕前：aOR=2.86，95%CI 1.98-4.13，aOR=1.11，95%CI 1.03-1.20[每 10μg/m 增加]；孕早期：aOR=3.10，95%CI 2.11-4.56）。基于单个月暴露窗口的分析基本显示出类似的正相关关系。此外，这些发现在敏感性分析中是稳健的，并且在亚组间基本一致。
我们的研究表明，孕前和孕早期 PM 暴露与多指畸形和并指畸形的风险增加有关。
