Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, 050017, PR China; Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China.
Department of Reproductive Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China.
Environ Res. 2022 May 1;207:112161. doi: 10.1016/j.envres.2021.112161. Epub 2021 Oct 7.
Congenital anomalies (CAs) are the leading causes for children's disabilities and mortalities worldwide. The associations between air pollution and CAs are not fully characterized in fetuses born by in vitro fertilization (IVF) who are at high risk of congenital anomalies.
We conducted a cross-sectional study including 16,971 IVF cycles from three hospitals in Hebei Province, China, 2014-2019. Air quality data was obtained from 149 air monitoring stations. Individual average daily concentrations of PM, PM, NO, SO, CO, and O were estimated by spatiotemporal kriging method. Exposure windows were divided into 5: preantral follicle period, antral follicle period, germinal period, embryonic period and early fetal period. Logistic generalized estimating equations were used to estimate the associations between air pollutants and overall or organ-system specific congenital anomalies. Negative control exposure method was used to detect and reduce bias of estimation.
We found increasing levels of PM and PM were associated with higher risk of overall congenital anomalies during early fetal period, equating gestation 10-12 weeks (OR: 1.05, 95% CI: 1.02-1.09, p = 0.013 for a 10 μg/m increase of PM; OR: 1.03, 95% CI: 1.01-1.06, p = 0.021 for a 10 μg/m increase of PM). Cleft lip and cleft palate were associated with PM in germinal period and early fetal period. The CAs of eye, ear, face and neck were related to CO in preantral follicle stage. We did not find an association between chromosome abnormalities and air pollution exposure.
We concluded that ambient air pollution was a risk factor for congenital anomalies in the fetuses conceived through IVF, especially exposure in early fetal period.
先天性畸形（CA）是全球儿童残疾和死亡的主要原因。在体外受精（IVF）出生的胎儿中，空气污染与 CA 之间的关联尚未完全确定，这些胎儿先天畸形的风险较高。
我们进行了一项横断面研究，纳入了 2014 年至 2019 年期间来自中国河北省的 3 家医院的 16971 个 IVF 周期。空气质量数据来自 149 个空气监测站。采用时空克里金法估计 PM、PM、NO、SO、CO 和 O 的个体日均浓度。暴露窗口分为 5 个时期：窦前卵泡期、窦卵泡期、生殖期、胚胎期和早期胎儿期。使用逻辑广义估计方程来估计空气污染物与整体或器官系统特异性先天性畸形之间的关联。采用负对照暴露方法来检测和减少估计偏差。
我们发现，在早期胎儿期，PM 和 PM 水平升高与整体先天性畸形的风险增加相关，相当于妊娠 10-12 周（OR：1.05，95%CI：1.02-1.09，p=0.013，每增加 10μg/m 的 PM；OR：1.03，95%CI：1.01-1.06，p=0.021，每增加 10μg/m 的 PM）。唇裂和腭裂与生殖期和早期胎儿期的 PM 有关。眼、耳、面和颈部的 CA 与窦前卵泡期的 CO 有关。我们没有发现染色体异常与空气污染暴露之间的关联。
我们得出结论，环境空气污染是体外受精胎儿先天性畸形的一个危险因素，尤其是在早期胎儿期的暴露。
