Heart Center, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
Environ Pollut. 2021 Oct 15;287:117629. doi: 10.1016/j.envpol.2021.117629. Epub 2021 Jun 22.
Preterm birth (PTB), defined as live birth before the 37th week of gestation, is believed to have profound impacts on the infant's health in later life. Air pollution has been suggested to be a potential risk factor of PTB, but the evidence was inconsistent. In this multicenter birth cohort study, we aimed to examine the association between fine particulate matter (PM) exposure during pregnancy and PTB in China. A total of 5976 live births were identified between Jan. 2009 and Feb. 2011 from 8 provinces in China. Residential exposures to PM were assigned based on satellite remote sensing estimates. Cox proportional hazards regressions were employed to explore the correlation for each trimester as well as the entire pregnancy. A total of 443 (7.4%) preterm births were observed. The average PM during pregnancy was 57.2 ± 8.8 μg/m. We found exposure to PM during the whole pregnancy (hazard ratio, HR = 1.262; 95% CI: 1.087-1.465) and in the first trimester (HR = 1.114; 95% CI: 1.007-1.232) was associated with higher risk of PTB. The associations of PM were stronger for subjects with older maternal or paternal age, lower maternal pre-pregnancy BMI, and lower family income. This study adds supports to the cumulating evidence linking PM exposure and elevated PTB risk. Measures of air pollution reduction are needed during pregnancy, especially at early stage of pregnancy to prevent adverse birth outcomes.
早产（PTB）定义为妊娠 37 周前的活产，据信对婴儿日后的健康有深远影响。空气污染被认为是 PTB 的一个潜在危险因素，但证据并不一致。在这项多中心出生队列研究中，我们旨在研究中国孕妇怀孕期间细颗粒物（PM）暴露与 PTB 之间的关系。在中国 8 个省份，我们于 2009 年 1 月至 2011 年 2 月期间确定了 5976 例活产。基于卫星遥感估计，为住宅暴露分配 PM。我们采用 Cox 比例风险回归来探讨每个孕期以及整个孕期的相关性。共观察到 443 例（7.4%）早产。怀孕期间 PM 的平均浓度为 57.2 ± 8.8μg/m。我们发现整个孕期（风险比，HR=1.262；95%置信区间：1.087-1.465）和孕早期（HR=1.114；95%置信区间：1.007-1.232）暴露于 PM 与 PTB 风险增加相关。对于母亲或父亲年龄较大、母亲孕前 BMI 较低、家庭收入较低的受试者，PM 的关联更强。本研究为 PM 暴露与升高的 PTB 风险之间的累积证据提供了支持。需要在怀孕期间采取减少空气污染的措施，特别是在妊娠早期，以预防不良的出生结局。
