Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy.
EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122, Milan, Italy.
Environ Res. 2022 Sep;212(Pt A):113216. doi: 10.1016/j.envres.2022.113216. Epub 2022 Mar 30.
Maternal exposure to air pollutants has been associated with pregnancy complications and adverse birth outcomes. Endothelial dysfunction, an imbalance in vascular function, during pregnancy is considered a key element in the development of pre-eclampsia. Environmental exposure to particulate matter (PM) during the first trimester of pregnancy might increase maternal inflammatory status thus affecting fetal growth, possibly leading to preterm delivery.
The purpose of the study was to evaluate possible effects of PM and PM exposure on fetal growth in healthy pregnant women at the end of the first trimester of pregnancy by investigating the relationship between circulating biomarkers of inflammation (IL-6), early systemic prothrombotic effects (CRP, plasma fibrinogen, PAI-1) and endothelial dysfunction (sICAM-1 and sVCAM-1).
295 pregnant women were recruited. Individual PM exposure was assigned to each subject by calculating the mean of PM and PM daily values observed during the 30, 60, and 90 days preceding enrolment (long-term) and single lag days back to fourteen days (short-term), and circulating plasma biomarkers were determined.
For long-term exposure, we observed an increase in sVCAM-1 and a decrease of PAI-1 levels for each 10 μg/m increase in PM concentration. Decreases in IL-6 and CRP levels were associated with each 10 μg/m PM increase. For short-term exposure, the levels of sVCAM-1 and PAI-1 were found to be associated with PM exposure, whereas fibrinogen levels were associated with PM exposure. Maternal plasmatic fibrinogen levels were negatively associated with the crown-rump length (p-value = 0.008).
The present study showed that both long- and short-term exposures to PM are associated with changes in circulating levels of biomarkers in pregnant women reflecting systemic inflammation and endothelial dysfunction/activation. Our findings support the hypothesis that inflammation and endothelial dysfunction might have a central role in modulating the detrimental effects of air pollution exposure during pregnancy.
母体暴露于空气污染物与妊娠并发症和不良出生结局有关。妊娠期间血管功能失衡的内皮功能障碍被认为是子痫前期发展的关键因素。妊娠早期暴露于颗粒物（PM）可能会增加母体炎症状态，从而影响胎儿生长，导致早产。
本研究旨在通过研究循环炎症生物标志物（IL-6）、早期全身促血栓形成效应（CRP、血浆纤维蛋白原、PAI-1）和内皮功能障碍（sICAM-1 和 sVCAM-1）与 PM 暴露与健康孕妇妊娠第一期末胎儿生长的关系，评估 PM 和 PM 暴露对胎儿生长的可能影响。
招募了 295 名孕妇。通过计算在入组前 30、60 和 90 天（长期）和回推至 14 天的单个滞后日（短期）观察到的 PM 和 PM 日值的平均值，为每位受试者分配个体 PM 暴露值，并确定循环血浆生物标志物。
对于长期暴露，我们观察到随着 PM 浓度每增加 10μg/m，sVCAM-1 增加，PAI-1 水平降低。随着 PM 每增加 10μg/m，IL-6 和 CRP 水平降低。对于短期暴露，sVCAM-1 和 PAI-1 水平与 PM 暴露相关，而纤维蛋白原水平与 PM 暴露相关。母体血浆纤维蛋白原水平与头臀长呈负相关（p 值=0.008）。
本研究表明，PM 的长期和短期暴露均与孕妇循环生物标志物水平的变化相关，反映了全身炎症和内皮功能障碍/激活。我们的研究结果支持这样一种假设，即炎症和内皮功能障碍可能在调节妊娠期间空气污染暴露的有害影响方面发挥核心作用。
