Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
Department of Medical Sciences, Uppsala University, Uppsala SE-751, Sweden.
Environ Int. 2022 Jul;165:107315. doi: 10.1016/j.envint.2022.107315. Epub 2022 May 21.
Increasing prevalence of childhood allergic rhinitis(AR) needs a deeper understanding on the potential adverse effects of early life exposure to air pollution.
The main aim was to evaluate the effects of maternal exposure to PM and chemical constituents during pregnancy on preschool children's AR, and further to explore the modification effects of regions and exclusive breastfeeding.
A multi-center population-based study was performed in 6 cities from 3 regions of China in 2011-2012. Maternal exposure to ambient PM and main chemical constituents(BC, OM, SO, NO, NH) during pregnancy was assessed and a longitudinal prospective analysis was applied on preschool children's AR. The modification effects of regions and exclusive breastfeeding were investigated.
A total of 8.8% and 9.8% of children reported doctor-diagnosed allergic rhinitis(DDAR) and current hay fever, respectively, and 48.6% had less than 6 months of exclusive breastfeeding. The means of PM during pregnancy were 52.7 μg/m, 70.3 μg/m and 76.4 μg/m in the east, north and central south of China, respectively. Multilevel log-binomial model regression showed that each interquartile range(IQR) increase of PM during pregnancy was associated with an average increase in prevalence ratio (PR) of DDAR by 1.43(95% confidence interval(CI): 1.11, 1.84) and current hay fever by 1.79(95% CI: 1.26, 2.55), respectively. Among chemical constituents, black carbon (BC) had the strongest associations. Across 3 regions, the eastern cities had the highest associations, followed by those in the central south and the north. For those equal to or longer than 6 months of exclusive breastfeeding, the associations were significantly reduced.
Children in east of China had the highest risks of developing AR per unit increase of maternal exposure to PM during pregnancy, especially BC constituent. Remarkable decline was found in association with an increase in breastfeeding for ≥6 months, in particular in east of China.
儿童过敏性鼻炎（AR）的患病率不断上升，需要深入了解生命早期暴露于空气污染的潜在不良影响。
本研究的主要目的是评估孕妇在怀孕期间接触 PM 和化学组分对学龄前儿童 AR 的影响，并进一步探讨区域和纯母乳喂养的修饰作用。
2011-2012 年，在中国 3 个地区的 6 个城市进行了一项多中心的基于人群的研究。评估了孕妇在怀孕期间接触环境 PM 和主要化学组分（BC、OM、SO、NO、NH）的情况，并对学龄前儿童 AR 进行了纵向前瞻性分析。研究了区域和纯母乳喂养的修饰作用。
共有 8.8%和 9.8%的儿童报告有医生诊断的过敏性鼻炎（DDAR）和当前的花粉热，分别有 48.6%的儿童母乳喂养时间少于 6 个月。怀孕期间 PM 的平均值分别为中国东部、北部和中南部的 52.7μg/m、70.3μg/m 和 76.4μg/m。多水平对数二项式模型回归显示，怀孕期间 PM 每增加一个四分位距（IQR），DDAR 的患病率比（PR）平均增加 1.43（95%置信区间（CI）：1.11，1.84），当前花粉热的 PR 平均增加 1.79（95%CI：1.26，2.55）。在化学组分中，黑碳（BC）的相关性最强。在 3 个区域中，东部城市的相关性最高，其次是中南部和北部城市。对于母乳喂养时间等于或长于 6 个月的儿童，相关性显著降低。
中国东部地区儿童在怀孕期间接触 PM 每增加一个单位，患 AR 的风险最高，尤其是 BC 成分。随着母乳喂养时间增加 6 个月以上，这种关联明显下降，特别是在中国东部。
