Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20892, USA.
Department of Global and Community Health, College of Health and Human Services, George Mason University, 4400 University Drive MS5B7, Fairfax, VA, 22030, USA.
Environ Res. 2021 May;196:110937. doi: 10.1016/j.envres.2021.110937. Epub 2021 Feb 26.
Air pollution is associated with mental health in the general population, but its influence on maternal mental health during pregnancy has not been assessed.
We evaluated the relationship between unspecified mental disorders complicating pregnancy and depression with average air pollution exposure during 3-months preconception, first trimester and whole pregnancy.
Ambient air pollution was derived from a modified Community Multiscale Air Quality model and mental health diagnoses were based on electronic intrapartum medical records. Logistic regression models assessed the odds of unspecified mental disorder complicating pregnancy (n = 11,577) and depression (n = 9793) associated with an interquartile range increase in particulate matter (PM) less than 2.5 μm (PM), PM, carbon monoxide (CO), nitrogen dioxide (NO), nitrogen oxide (NO), sulfur dioxide (SO), and ozone (O). Pregnancies without mental health disorders were the reference group (n = 211,645). Models were adjusted for maternal characteristics and study site; analyses were repeated using cases with no additional mental health co-morbidity.
Whole pregnancy exposure to PM, PM, NO, and NO was associated with a 29%-74% increased odds of unspecified mental disorders complicating pregnancy while CO was associated with 31% decreased odds. Results were similar for depression: whole pregnancy exposure to PM, PM, NO, and NO was associated with 11%-21% increased odds and CO and O were associated with 16%-20% decreased odds. SO results were inconsistent, with increased odds for unspecified mental disorders complicating pregnancy and decreased odds for depression. While most findings were similar or stronger among cases with no co-morbidity, PM and NO were associated with reduced risk and SO with increased risk for depression only.
Whole pregnancy exposure to PM, PM, NO, and NO were associated with unspecified mental disorder complicating pregnancy and depression, but some results varied for depression only. These risks merit further investigation.
空气污染与一般人群的心理健康有关，但尚未评估其对孕妇怀孕期间心理健康的影响。
我们评估了在妊娠前 3 个月、妊娠早期和整个妊娠期间平均空气污染暴露与未指明的妊娠合并精神障碍和抑郁之间的关系。
环境空气污染源自改良的社区多尺度空气质量模型，精神健康诊断基于电子围产期医疗记录。使用逻辑回归模型评估未指明的妊娠合并精神障碍（n=11577）和抑郁（n=9793）与颗粒物（PM）小于 2.5μm（PM）、PM、一氧化碳（CO）、二氧化氮（NO）、氮氧化物（NO）、二氧化硫（SO）和臭氧（O）的四分位距增加相关的几率。无精神健康障碍的妊娠为参考组（n=211645）。模型调整了母体特征和研究地点；使用无其他精神健康合并症的病例重复了分析。
整个妊娠期间暴露于 PM、PM、NO 和 NO 与未指明的妊娠合并精神障碍的几率增加 29%-74%相关，而 CO 与几率降低 31%相关。抑郁的结果相似：整个妊娠期间暴露于 PM、PM、NO 和 NO 与几率增加 11%-21%相关，而 CO 和 O 与几率降低 16%-20%相关。SO 的结果不一致，与未指明的妊娠合并精神障碍的几率增加和抑郁的几率降低相关。虽然大多数发现对于无合并症的病例相似或更强，但 PM 和 NO 与抑郁的风险降低相关，而 SO 仅与抑郁的风险增加相关。
整个妊娠期间暴露于 PM、PM、NO 和 NO 与未指明的妊娠合并精神障碍和抑郁相关，但一些结果仅与抑郁相关。这些风险值得进一步研究。
