产前暴露于环境空气多污染物会显著损害宫内胎儿发育轨迹。
Prenatal exposure to ambient air multi-pollutants significantly impairs intrauterine fetal development trajectory.
机构信息
Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
Ecotoxicol Environ Saf. 2020 Sep 15;201:110726. doi: 10.1016/j.ecoenv.2020.110726. Epub 2020 May 29.
BACKGROUND
Impaired in utero fetal growth trajectory may have long term health consequences of the newborns and increase risk of adulthood metabolic diseases. Prenatal exposure to air pollution has been linked to fetal development restriction; however, the impact of exposure to ambient air pollutants on the entire course of intrauterine fetal development has not been comprehensively investigated.
METHODS
During 2015-2018, two cohorts of mother-infant dyads (N = 678 and 227) were recruited in Shanghai China, from which three categories of data were systematically collected: (1) daily exposure to six air pollutants during pregnancy, (2) fetal biometry in the 2nd (gestational week 24, [GW24]) and 3rd trimester (GW36), and (3) neonatal outcomes at birth. We investigated the impact of prenatal exposure to air pollutant mixture on the trajectory of fetal development during the course of gestation, adjusting for a broad set of potential confounds.
RESULTS
Prenatal exposure to PM, PM, SO and O significantly reduced fetal biometry at GW24, where SO had the most potent effect. For every 10 μg/m increment increase of daily SO exposure during the 1st trimester shortened femur length by 2.20 mm (p = 6.7E-21) translating to 5.3% reduction from the average of the study cohort. Prenatal air pollution exposure also decreased fetal biometry at GW36 with attenuated effect size. Comparing to the lowest exposed quartile, fetus in the highest exposed quartile had 6.3% (p = 3.5E-5) and 2.1% (p = 2.4E-3) lower estimated intrauterine weight in GW24 and GW36, respectively; however, no difference in birth weight was observed, indicating a rapid catch-up growth in the 3rd trimester.
CONCLUSIONS
To our knowledge, for the first time, we demonstrated the impact of prenatal exposure to ambient air pollutants on the course of intrauterine fetal development. The altered growth trajectory and rapid catch-up growth in associated with high prenatal exposure may lead to long-term predisposition for adulthood metabolic disorders.
背景
宫内胎儿生长轨迹受损可能对新生儿有长期健康影响，并增加成年期代谢性疾病的风险。产前暴露于空气污染与胎儿发育受限有关；然而，暴露于环境空气污染物对整个宫内胎儿发育过程的影响尚未得到全面研究。
方法
在 2015 年至 2018 年期间，在中国上海招募了两个母婴队列（N=678 和 227），系统收集了以下三类数据：（1）怀孕期间六种空气污染物的每日暴露情况；（2）妊娠第 2 期（妊娠周 24 周，[GW24]）和第 3 期（GW36）的胎儿生物测量；（3）新生儿出生时的结局。我们研究了产前暴露于空气污染物混合物对妊娠期间胎儿发育轨迹的影响，同时调整了广泛的潜在混杂因素。
结果
产前暴露于 PM、PM、SO 和 O 显著降低了 GW24 的胎儿生物测量值，其中 SO 的影响最大。在第 1 孕期，每日 SO 暴露量每增加 10μg/m，股骨长度缩短 2.20mm（p=6.7E-21），相当于研究队列平均水平的 5.3%减少。产前空气污染暴露也降低了 GW36 的胎儿生物测量值，但效应大小减弱。与最低暴露 quartile 相比，最高暴露 quartile 的胎儿在 GW24 和 GW36 时的宫内体重分别降低了 6.3%（p=3.5E-5）和 2.1%（p=2.4E-3）；然而，出生体重没有差异，表明在第 3 孕期快速追赶生长。
结论
据我们所知，这是首次证明产前暴露于环境空气污染物对宫内胎儿发育过程的影响。与高产前暴露相关的生长轨迹改变和快速追赶生长可能导致成年期代谢性疾病的长期易感性。
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