Medical Research Center/State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
Environ Health. 2022 May 6;21(1):48. doi: 10.1186/s12940-022-00859-7.
Polycyclic aromatic hydrocarbons (PAHs) and its DNA adducts has been suggested to increase the risk of preterm birth (PB). Yet, few studies have been conducted to investigate this association, and the role of dietary nutrients intakes including vitamins, folate, and carotene during pre- and post-conception on this association has not been studied.
Building upon a birth cohort in Taiyuan China, we conducted a nested case control study including 83 PB and 82 term births. Benzo[a]pyrene (BaP)-DNA adducts were measured by an improved LC-MC/MC analytic method. Dietary nutrient intakes were estimated from food frequency questionnaire using the Chinese Standard Tables of Food Consumption. Multivariable logistic regression model was used to examine the associations.
Increased risk of PB was observed as per interquartile increase in maternal BaP-DNA adduct level (OR = 1.27, 95%CI 0.95-1.67). Compared to low level (below mean) of maternal adducts, high level (above mean) of adducts was associated with the risk of PB (OR = 2.05, 95%CI 1.05-4.01). After stratified by dietary nutrients intakes, high adducts levels were associated with approximately 2-fourfold times increases in risk of PB among women with low vitamin A, C, E, folate, and carotene intakes during pre- and/or post-conception. Stronger stratified associations were consistently seen during preconception. Similar patterns were observed after additional adjustment for supplementation.
Our study supports the hypothesis that high level of maternal PAHs exposure was significantly associated with increased risk of PB, and provides the first evidence that dietary vitamins, carotene, and folate intake levels may modify this association during different pregnancy windows. Our findings are relevant to identify recommendation for environment management and prenatal nutrition regarding pregnant women and newborns. Further investigation in other populations is warranted.
多环芳烃（PAHs）及其 DNA 加合物已被认为会增加早产（PB）的风险。然而，很少有研究调查这种关联，也没有研究在受孕前和受孕后饮食营养素（包括维生素、叶酸和类胡萝卜素）摄入量在这种关联中的作用。
本研究基于中国太原的一个出生队列，进行了一项巢式病例对照研究，纳入了 83 例早产和 82 例足月出生的婴儿。通过改进的 LC-MC/MC 分析方法测量苯并[a]芘（BaP）-DNA 加合物。使用中国食物消费标准表，通过食物频率问卷估计饮食营养素摄入量。采用多变量逻辑回归模型来检验关联。
与母亲 BaP-DNA 加合物水平的四分位间距增加相比，观察到 PB 风险增加（OR=1.27，95%CI 0.95-1.67）。与低水平（低于平均值）的母体加合物相比，高水平（高于平均值）的加合物与 PB 风险相关（OR=2.05，95%CI 1.05-4.01）。按饮食营养素摄入量分层后，在受孕前和/或受孕期间维生素 A、C、E、叶酸和类胡萝卜素摄入量低的女性中，高水平的加合物与 PB 风险增加约 2-4 倍相关。在受孕前分层关联更强。在进一步调整补充剂后，也观察到类似的模式。
我们的研究支持这样的假设，即高水平的母体 PAHs 暴露与 PB 风险增加显著相关，并提供了第一个证据，表明在不同的妊娠窗口期，饮食中的维生素、类胡萝卜素和叶酸摄入量可能会改变这种关联。我们的研究结果与为孕妇和新生儿制定有关环境管理和产前营养的建议有关。需要在其他人群中进行进一步的研究。
