Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, People's Republic of China.
Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China.
Chemosphere. 2021 Nov;283:131169. doi: 10.1016/j.chemosphere.2021.131169. Epub 2021 Jun 13.
More and more studies began to explore the hazardous health effects of PM, but few reported its impacts on stillbirth. The sparse results were inconsistent and remained to be integrated. Therefore, we aimed to reveal the association between maternal exposure to PM and stillbirth.
In this meta-analysis, we searched PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for related articles written in English and published before October 18, 2020. Study selection was conducted according to the predetermined criteria and data attraction was done with predesigned form. A new instrument was applied to conduct the risk of bias assessment. And random-effect models were used to pool the estimates.
A total of 3655 records were identified from the databases, but only 7 studies were ultimately included in this study. Positive association was found between the maternal exposure to PM (per 10 μg/m increased) in the entire pregnancy (OR: 1.15, 95% CI: 1.07-1.25) and third trimester (OR: 1.09, 95% CI: 1.01-1.18) and stillbirth, but the association between the maternal exposure to PM (per 10 μg/m increased) in the first trimester (OR: 1.01, 95% CI: 0.90-1.13) and second trimester (OR: 1.06, 95% CI: 0.98-1.14) and stillbirth was not statistically significant. Besides, there was no publication bias.
Maternal exposure to PM in the entire pregnancy and third trimester was associated with elevated risk of stillbirth. However, due to the high heterogeneity, further pathophysiological researches and high quality population studies were still warranted.
越来越多的研究开始探索 PM 对健康的危害,但很少有研究报告其对死产的影响。结果稀少且不一致,需要进行整合。因此,我们旨在揭示母体暴露于 PM 与死产之间的关联。
在这项荟萃分析中,我们检索了 PubMed、Web of Science、Embase 和 Cochrane 对照试验中心注册库(CENTRAL)中发表于 2020 年 10 月 18 日前的相关英文文章。根据预定标准进行研究选择,并使用预设计表格进行数据提取。应用新工具进行偏倚风险评估,并使用随机效应模型汇总估计值。
从数据库中总共确定了 3655 条记录,但最终只有 7 项研究纳入本研究。在整个孕期(OR:1.15,95%CI:1.07-1.25)和孕晚期(OR:1.09,95%CI:1.01-1.18),母体暴露于 PM(每增加 10μg/m³)与死产呈正相关,但在孕早期(OR:1.01,95%CI:0.90-1.13)和孕中期(OR:1.06,95%CI:0.98-1.14),母体暴露于 PM(每增加 10μg/m³)与死产之间的关联无统计学意义。此外,不存在发表偏倚。
整个孕期和孕晚期母体暴露于 PM 与死产风险增加相关。然而,由于存在高度异质性,仍需要进一步的病理生理学研究和高质量的人群研究。