National Research Institute for Health and Family Planning, Beijing, China; National Human Genetic Resources Center, Beijing, 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.
J Hazard Mater. 2022 Mar 5;425:127645. doi: 10.1016/j.jhazmat.2021.127645. Epub 2021 Nov 1.
BACKGROUND: Potential hazards of fine particulate matter (PM) constituents on preterm birth (PTB) have rarely been explored in China. OBJECTIVE: To quantify the associations of PM constituents with PTB. METHODS: This study was based on a nationwide cohort of 3,723,169 live singleton births delivered between January 2010 and December 2015 in China. We applied satellite-based estimates of 5 PM constituents (organic carbon; black carbon; sulfate; ammonium; and nitrate). We used Cox proportional hazards regression models adjusted for individual covariates, temperature, humidity, and seasonality to evaluate the associations. RESULTS: During the entire pregnancy, each interquartile range (29 μg/m) increase in PM concentrations was associated with a 7% increase in PTB risk [hazard ratio (HR): 1.07; 95% confidence interval (CI): 1.07-1.08). We observed the largest effect estimates on carbonaceous components (HR: 1.09; 95% CI: 1.08-1.10 for organic carbon and black carbon). Early pregnancy appeared to be the critical exposure window for most constituents. Women who were older, exposed to second-hand smoke, overweight or obese before pregnancy, conceived during winter, and living in northern China or rural areas were more susceptible. CONCLUSIONS: Carbonaceous components of PM were associated with higher PTB risk. Findings on characteristics of vulnerability underlined targeted protections on susceptible subgroups.
背景:在中国,细颗粒物(PM)成分对早产(PTB)的潜在危害很少被探索。
目的:量化 PM 成分与 PTB 的关联。
方法:本研究基于中国 2010 年 1 月至 2015 年 12 月期间全国范围内的 3723169 例活单胎分娩的队列。我们应用基于卫星的 5 种 PM 成分(有机碳;黑碳;硫酸盐;铵;和硝酸盐)的估算值。我们使用 Cox 比例风险回归模型,调整了个体协变量、温度、湿度和季节性,以评估关联。
结果:在整个孕期中,PM 浓度每增加一个四分位距(29μg/m),PTB 风险增加 7%[风险比(HR):1.07;95%置信区间(CI):1.07-1.08]。我们观察到碳质成分的最大效应估计值(HR:1.09;95% CI:1.08-1.10,有机碳和黑碳)。早期妊娠似乎是大多数成分的关键暴露窗口。年龄较大、暴露于二手烟、妊娠前超重或肥胖、冬季受孕以及居住在中国北方或农村地区的妇女更容易受到影响。
结论:PM 的碳质成分与较高的 PTB 风险相关。脆弱性特征的发现强调了针对易感亚组的有针对性保护。
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