Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China.
Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China.
Environ Res. 2020 Sep;188:109752. doi: 10.1016/j.envres.2020.109752. Epub 2020 May 30.
Given the inconsistency of epidemiologic evidence for associations between maternal exposures to traffic-related metrics and adverse birth outcomes, this manuscript aims to provide clarity on this topic. Pooled meta-estimates were calculated using random-effects analyses. Subgroup analyses were conducted by study area, study design, and Newcastle-Ottawa quality score (NOS). Funnel plots and Egger's test were conducted to evaluate the publication bias, and Fail-safe Numbers (Fail-safe N) were measured to evaluate the robustness of models. From the initial 740 studies (last search, July 11, 2019), 26 studies were included in our analysis. The pooled odds ratio for the change in small for gestational age associated with per 500 m decrease in the distance to roads was 1.016 (95% CI: 1.004, 1.029). Subgroup analyses revealed significant positive associations between term low birth weight and traffic density in higher-quality literatures with higher NOS [1.060 (95% CI: 1.002, 1.121)], cohort studies [1.020 (95% CI: 1.006, 1.033)], and studies in North America [1.018 (95% CI: 1.005, 1.131)]. The buffer of traffic density made no difference in the effect size. Traffic density seemed to be a better indicator of traffic pollution than the distance to roads.
鉴于母体暴露于与交通相关的指标与不良出生结局之间的关联的流行病学证据不一致，本文旨在阐明这一主题。使用随机效应分析计算了汇总荟萃估计。通过研究区域、研究设计和纽卡斯尔-渥太华质量评分（NOS）进行了亚组分析。进行了漏斗图和 Egger 检验以评估发表偏倚，并测量了失效安全数（失效安全 N）以评估模型的稳健性。从最初的 740 项研究（最后一次搜索，2019 年 7 月 11 日）中，有 26 项研究纳入了我们的分析。与道路距离每减少 500 米相关的小于胎龄儿的变化与每减少 500 米相关的小胎龄儿的比值比为 1.016（95%CI：1.004，1.029）。亚组分析显示，在 NOS 较高的高质量文献中，交通密度与足月低出生体重之间存在显著正相关[1.060（95%CI：1.002，1.121）]、队列研究[1.020（95%CI：1.006，1.033）]和北美研究[1.018（95%CI：1.005，1.131）]。交通密度的缓冲对效应大小没有影响。交通密度似乎是交通污染的一个比道路距离更好的指标。
