State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
Environ Sci Pollut Res Int. 2020 Aug;27(23):29280-29290. doi: 10.1007/s11356-020-09014-6. Epub 2020 May 21.
With the accelerated pace of economic development and modernization, air pollution has become one of the most focused public health problems. However, the impact of particulate matter exposure during pregnancy on childhood asthma and wheezing remains controversial. We performed this meta-analysis to explore the relationship between prenatal exposure to PM and childhood asthma and wheezing. Candidate papers were searched on PubMed, Web of Science, Embase, and Cochrane Library before July 15, 2019. The main characteristics of the included studies were extracted, and the quality was evaluated by the Newcastle-Ottawa Scale (NOS). A sensitivity analysis was performed to assess the impact of individual studies on the combined effects. The Egger and Begg tests were conducted to examine the publication bias. Nine studies were included in the final analysis. Prenatal exposure to PM significantly increased the risk of childhood asthma and wheezing (OR = 1.06, 95% CI 1.02-1.11; per 5 μg/m). Maternal exposure was more strongly related to childhood asthma and wheezing before age 3 (OR = 1.15, 95% CI 1.00-1.31; per 5 μg/m) than after (OR = 1.04, 95% CI 1.00-1.09; per 5 μg/m). Children in developed countries showed more severe effects (OR = 1.14, 95% CI 1.02-1.27; per 5 μg/m). Children who were born to mothers with higher levels of prenatal exposure were at higher risk of asthma and wheezing (OR = 1.07, 95% CI 1.02-1.13; per 5 μg/m). This meta-analysis indicated that the impact of PM on childhood asthma and wheezing begins as early as utero, so regulating pollutant emission standards and strengthening prenatal protection are crucial to maternal and child health.
随着经济发展和现代化进程的加速，空气污染已成为最受关注的公共卫生问题之一。然而，孕期暴露于颗粒物对儿童哮喘和喘息的影响仍存在争议。我们进行了这项荟萃分析，以探讨孕期暴露于 PM 与儿童哮喘和喘息之间的关系。在 2019 年 7 月 15 日之前，我们在 PubMed、Web of Science、Embase 和 Cochrane Library 上搜索了候选论文。提取纳入研究的主要特征，并使用 Newcastle-Ottawa 量表（NOS）评估质量。进行敏感性分析以评估个别研究对合并效应的影响。使用 Egger 和 Begg 检验检查发表偏倚。最终有 9 项研究纳入了分析。孕期暴露于 PM 显著增加了儿童哮喘和喘息的风险（OR=1.06，95%CI 1.02-1.11；每增加 5μg/m）。与儿童在 3 岁后（OR=1.04，95%CI 1.00-1.09；每增加 5μg/m）相比，母亲在孕期暴露于 PM 与儿童在 3 岁前（OR=1.15，95%CI 1.00-1.31；每增加 5μg/m）的关系更强。在发达国家，儿童的影响更为严重（OR=1.14，95%CI 1.02-1.27；每增加 5μg/m）。母亲孕期暴露水平较高的儿童患哮喘和喘息的风险更高（OR=1.07，95%CI 1.02-1.13；每增加 5μg/m）。这项荟萃分析表明，PM 对儿童哮喘和喘息的影响早在宫内就开始了，因此，调节污染物排放标准和加强孕期保护对母婴健康至关重要。
