Michikawa Takehiro, Morokuma Seiichi, Takeda Yuki, Yamazaki Shin, Nakahara Kazushige, Takami Akinori, Yoshino Ayako, Sugata Seiji, Saito Shinji, Hoshi Junya, Kato Kiyoko, Nitta Hiroshi, Nishiwaki Yuji
Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan.
Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Int J Epidemiol. 2022 Feb 18;51(1):191-201. doi: 10.1093/ije/dyab192.
Our hypothesis was that exposure to fine particulate matter (PM2.5) is related to abnormal cord insertion, which is categorized as a form of placental implantation abnormality. We investigated the association between exposure to total PM2.5 and its chemical components over the first trimester and abnormal cord insertion, which contributes to the occurrence of adverse birth outcomes.
From the Japan Perinatal Registry Network database, we used data on 83 708 women who delivered singleton births at 39 cooperating hospitals in 23 Tokyo wards (2013-2015). We collected PM2.5 on a filter and measured daily concentrations of carbon and ion components. Then, we calculated the average concentrations over the first trimester (0-13 weeks of gestation) for each woman. A multilevel logistic-regression model with the hospital as a random effect was used to estimate the odds ratios (ORs) of abnormal cord insertion.
Among the 83 708 women (mean age at delivery = 33.7 years), the frequency of abnormal cord insertion was 4.5%, the median concentration [interquartile range (IQR)] of total PM2.5 was 16.1 (3.61) μg/m3 and the OR per IQR for total PM2.5 was 1.14 (95% confidence interval = 1.06-1.23). In the total PM2.5-adjusted models, total carbon, organic carbon, nitrate, ammonium and chloride were positively associated with abnormal insertion. Organic carbon was consistently, and nitrate tended to be, associated with specific types of abnormal insertion (marginal or velamentous cord insertion).
Exposure to total PM2.5 and some of its components over the first trimester increased the likelihood of abnormal cord insertion.
我们的假设是，暴露于细颗粒物（PM2.5）与脐带插入异常有关，脐带插入异常被归类为胎盘植入异常的一种形式。我们调查了孕早期暴露于总PM2.5及其化学成分与脐带插入异常之间的关联，脐带插入异常会导致不良分娩结局的发生。
我们从日本围产期登记网络数据库中，使用了在东京23个区的39家合作医院分娩单胎的83708名女性的数据（2013 - 2015年）。我们在滤纸上收集PM2.5，并测量碳和离子成分的每日浓度。然后，我们计算了每位女性孕早期（妊娠0 - 13周）的平均浓度。使用以医院为随机效应的多水平逻辑回归模型来估计脐带插入异常的比值比（OR）。
在这83708名女性中（分娩时平均年龄 = 33.7岁），脐带插入异常的发生率为4.5%，总PM2.5的中位数浓度[四分位间距（IQR）]为16.1（3.61）μg/m³，总PM2.5每增加一个IQR的OR为1.14（95%置信区间 = 1.06 - 1.23）。在总PM2.5校正模型中，总碳、有机碳（OC）、硝酸盐、铵和氯化物与异常插入呈正相关。有机碳始终与特定类型的异常插入（边缘性或帆状脐带插入）相关，硝酸盐也倾向于与特定类型的异常插入相关。
孕早期暴露于总PM2.5及其某些成分会增加脐带插入异常的可能性。
