Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China.
State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China.
Sci Total Environ. 2022 Jul 10;829:154564. doi: 10.1016/j.scitotenv.2022.154564. Epub 2022 Mar 15.
The association between ambient fine particulate matter (PM) and systemic inflammation in women with early pregnancy is unclear. This study estimated the effects of PM exposures on inflammatory biomarkers in women with normal early pregnancy (NEP) or clinically recognized early pregnancy loss (CREPL). Serum interleukin-1beta (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured in 228 early pregnant women recruited in Tianjin, China. Maternal PM exposures at lag 0 through lag 30 before blood collection were estimated using temporally-adjusted land use regression models. Daily exposures to ambient PM, NO, SO, CO and 8-hours maximum ozone were estimated using city-level concentrations. Single-day lag effects at lag 0 through lag 7 were estimated using multivariable linear regression models. Distributed lag effects and cumulative effects over the preceding seven days and 30 days were estimated using distributed lag non-linear models. Serum IL-1β (8.0% increase at lag 3), IL-6 (33.9% increase at lag 5) and TNF-α (12.7% increase at lag 5) in early pregnant women were significantly increased with an interquartile range increase in PM exposures adjusted for temporal confounders and demographic characteristics. These effects were robust in several two-pollutant models. Distributed lag effects over the preceding 30 days also showed that the three cytokines were significantly increased with PM on some lag days. Among all cumulative effects of PM on the three cytokines in all subjects or in the two groups, only IL-6 was significantly increased in CREPL women over the preceding seven days and 30 days. No significant cumulative effect of PM was observed in NEP women. In conclusion, exposure to ambient PM may induce systemic inflammation in women in the first trimester of pregnancy. Whether the PM-related cumulative increase in maternal IL-6 is involved in the pathogenic mechanisms of early pregnancy loss needs to be identified in future research.
大气细颗粒物（PM）与早孕妇女全身炎症之间的关系尚不清楚。本研究估计了 PM 暴露对正常早孕（NEP）或临床确诊早孕丢失（CREPL）妇女中炎症生物标志物的影响。在中国天津招募了 228 名早孕妇女，测量了她们的血清白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）。使用时间调整的土地利用回归模型估算了血液采集前 0 至 30 天的母体 PM 暴露。使用城市水平浓度估计每日环境 PM、NO、SO、CO 和 8 小时最大臭氧暴露。使用多变量线性回归模型估计了滞后 0 至 7 天的单日滞后效应。使用分布式滞后非线性模型估计了前七天和前 30 天的分布滞后效应和累积效应。调整时间混杂因素和人口统计学特征后，与 PM 暴露的四分位距增加相比，早期孕妇血清中 IL-1β（滞后 3 时增加 8.0%）、IL-6（滞后 5 时增加 33.9%）和 TNF-α（滞后 5 时增加 12.7%）显著增加。在几个双污染物模型中，这些影响是稳健的。前 30 天的分布滞后效应也表明，在一些滞后日，三种细胞因子随着 PM 的增加而显著增加。在所有研究对象或两组中 PM 对三种细胞因子的所有累积效应中，仅在 CREPL 妇女中，前 7 天和前 30 天的 IL-6 显著增加。在 NEP 妇女中未观察到 PM 的累积效应。总之，暴露于大气 PM 可能会引起妊娠早期妇女的全身炎症。PM 相关的母体 IL-6 累积增加是否参与了早孕丢失的发病机制，需要在未来的研究中确定。
