Willis Mary, Hystad Perry
School of Biological & Population Health Sciences, College of Public Health & Human Sciences, Oregon State University, Corvallis, Oregon.
Environ Epidemiol. 2019 Feb 12;3(1):e034. doi: 10.1097/EE9.0000000000000034. eCollection 2019 Feb.
The impact of multiple hazardous air pollutant (HAP) exposures during pregnancy on adverse birth outcomes is unknown. We examined associations between cumulative and individual HAP exposures and adverse birth outcomes in Portland, OR, a region that has exceeded HAP air quality guidelines for decades.
We used vital statistics records in the Portland Metropolitan Region from 2000 to 2014 (n = 279,051 births). Prenatal exposure to 19 HAPs was assessed using a dispersion model applied to maternal residential address at delivery. We used linear and logistic multivariate regression models to assess associations between individual and cumulative HAP exposures and preterm term (PTB), term birth weight (TBW), and small for gestational age (SGA), adjusting for several potential individual and neighborhood confounding factors.
We observed no associations for composite HAP exposure metrics and adverse birth outcomes. Associations were observed in fully adjusted models comparing the highest to lowest quintiles of exposure for certain HAPs including chromium VI and TBW (-12.70; 95% confidence interval [CI]: -23.10, -2.31); 1,3-butadiene and TBW (-16.86; 95% CI: -29.66, -4.06) and SGA (1.18; 95% CI: 1.07, 1.30); and cadmium and TBW (-31.37; 95% CI: -56.20, -.54). For some HAP metrics, we observed higher HAP exposures for minority groups and large unadjusted associations between other HAPs and adverse birth outcomes, but most associations were attenuated in adjusted models.
Adverse birth outcomes were not consistently associated with most HAP exposures in Portland, OR, although some specific air toxic exposures warrant further attention.
孕期暴露于多种有害空气污染物（HAP）对不良出生结局的影响尚不清楚。我们研究了俄勒冈州波特兰市累积和个体HAP暴露与不良出生结局之间的关联，该地区数十年来一直超过HAP空气质量指南。
我们使用了2000年至2014年波特兰都会区的生命统计记录（n = 279,051例出生）。使用应用于分娩时产妇居住地址的扩散模型评估孕期对19种HAP的暴露情况。我们使用线性和逻辑多变量回归模型评估个体和累积HAP暴露与早产（PTB）、足月出生体重（TBW）和小于胎龄儿（SGA）之间的关联，并对几个潜在的个体和邻里混杂因素进行了调整。
我们未观察到复合HAP暴露指标与不良出生结局之间的关联。在完全调整的模型中，观察到某些HAP（包括六价铬和TBW（-12.70；95%置信区间[CI]：-23.10，-2.31）；1,3 - 丁二烯和TBW（-16.86；95%CI：-29.66，-4.06）以及SGA（1.18；95%CI：1.07，1.30）；镉和TBW（-31.37；95%CI：-56.20，-0.54））暴露最高与最低五分位数比较时存在关联。对于一些HAP指标，我们观察到少数群体的HAP暴露较高，以及其他HAP与不良出生结局之间存在较大的未调整关联，但大多数关联在调整模型中减弱。
在俄勒冈州波特兰市，不良出生结局与大多数HAP暴露之间没有一致的关联，尽管某些特定的空气有毒物质暴露值得进一步关注。
