急性环境大气污染暴露与 NICHD 胎儿生长研究-单胎队列的胎盘多普勒结果。
Acute ambient air pollution exposure and placental Doppler results in the NICHD fetal growth studies - Singleton cohort.
机构信息
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
Department of Atmospheric and Oceanic Science, University of Maryland, College Park, MD, USA.
出版信息
Environ Res. 2021 Nov;202:111728. doi: 10.1016/j.envres.2021.111728. Epub 2021 Jul 21.
BACKGROUND
Increased placental vascular resistance is a proposed mechanism by which air pollution exposure during pregnancy lowers birth weight and increases pregnancy-induced hypertensive disorders.
OBJECTIVE
To examine the impact of acute air pollution exposure during pregnancy on uterine and umbilical artery Doppler indicators of placental vascular resistance.
METHODS
After a first ultrasound to confirm gestational age, 2562 pregnant women recruited in 12 clinics throughout the United States underwent up to five standardized ultrasounds with Doppler measurements. Exposures to 11 air pollutants were estimated for the hour of ultrasound and each of the 2 h prior to ultrasound at the clinics using the National Air Quality Forecast Capability reanalysis products. We used mixed logistic regression to study the longitudinal odds ratio (OR) of any, uni- or bi-lateral systolic and diastolic uterine artery notching compared to no notching and the longitudinal OR of abnormal end diastolic flow of the umbilical artery compared to forward flow. Uterine and umbilical artery resistance indexes were studied using linear mixed models.
RESULTS
Each inter-quartile range (IQR) increase of particulate matter < 2.5 μm, nitrate, ammonium, primary organic matter (POM) and nitrogen dioxide during the hour of ultrasound was associated with a decreased risk of unilateral systolic notch and with increased resistance index of the left uterine artery. For the umbilical artery, each IQR increase in ozone was associated with decreased resistance index (b: -0.26, 95 % CI: -0.52, -0.01) and with a decreased risk of abnormal end diastolic flow (OR: 0.36, 95 % CI: 0.14, 0.94); while each IQR increase of elemental carbon and POM was associated with increased risk of abnormal end diastolic flow (OR: 1.47, 95 % CI: 1.02, 2.13 and OR: 1.67, 95 % CI: 1.17, 2.39, respectively).
DISCUSSION
Our results suggest acute air pollution exposure may influence placental vascular resistance.
背景
妊娠期间胎盘血管阻力增加被认为是空气污染暴露降低出生体重和增加妊娠高血压疾病的一种机制。
目的
检测妊娠期间急性空气污染暴露对子宫和脐动脉多普勒胎盘血管阻力指标的影响。
方法
在首次超声确认孕周后，在美国 12 家诊所招募了 2562 名孕妇，进行了多达 5 次标准化超声检查和多普勒测量。使用国家空气质量预测能力再分析产品，在诊所对超声小时和超声前 2 小时的 11 种空气污染物暴露进行了估计。我们使用混合逻辑回归研究了与无切迹相比，任何、单侧或双侧子宫动脉收缩期和舒张期切迹以及与正向血流相比脐动脉舒张末期异常血流的纵向比值比（OR）。使用线性混合模型研究了子宫和脐动脉阻力指数。
结果
在超声小时内，每增加一个四分位间距（IQR）的颗粒物<2.5μm、硝酸盐、铵、一次有机物（POM）和二氧化氮与单侧收缩期切迹的风险降低相关，与左侧子宫动脉阻力指数增加相关。对于脐动脉，每增加一个 IQR 的臭氧与阻力指数降低相关（b：-0.26，95%CI：-0.52，-0.01）和异常舒张末期血流的风险降低相关（OR：0.36，95%CI：0.14，0.94）；而每增加一个 IQR 的元素碳和 POM 与异常舒张末期血流的风险增加相关（OR：1.47，95%CI：1.02，2.13 和 OR：1.67，95%CI：1.17，2.39）。
讨论
我们的结果表明，急性空气污染暴露可能影响胎盘血管阻力。
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