孕期母体暴露于混合空气污染物与子代先天性心脏病的关系。
Risk of maternal exposure to mixed air pollutants during pregnancy for congenital heart diseases in offspring.
机构信息
1. Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
2. Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
出版信息
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2022 Jun 25;51(3):326-333. doi: 10.3724/zdxbyxb-2022-0073.
OBJECTIVE
To explore the risk of maternal exposure to mixed air pollutants of particulate matter 1 (PM ), particulate matter 2.5 (PM ), particulate matter 10 (PM ) and NO for congenital heart disease (CHD) in offspring, and to estimate the ranked weights of the above pollutants.
METHODS
6038 CHD patients and 5227 healthy controls from 40 medical institutions in 21 cities in Guangdong Registry of Congenital Heart Disease (GRCHD) from 2007 to 2016 were included. Logistic regression model was used to estimate the effect of maternal exposure to a single air pollutant on the occurrence of CHD in offspring. Spearman correlation coefficient was used to analyze the correlation between various pollutants, and Quantile g-computation was used to evaluate the joint effects of mixed exposure of air pollutants on CHD and the weights of various pollutants.
RESULTS
The exposure levels of PM , PM , PM and NO in the CHD group were significantly higher than those in the control group (all <0.01). The correlation coefficients among PM , PM , PM and NO were greater than 0.80. PM , PM , PM and NO exposure were associated with a significantly increased risk of CHD in offspring. Mixed exposure of these closely correlated pollutants presented much stronger effect on CHD than exposure of any single pollutants. There was a monotonic increasing relationship between mixed exposure and CHD risk. For each quantile increase in mixed exposure, the risk of CHD increased by 47% ( =1.47, 95% : 1.34-1.61). Mixed exposure had greater effect on CHD in the early pregnancy compared with middle and late pregnancy, but the greatest effect was the exposure in the whole pregnancy. The weight of PM is the highest in the mixed exposure (81.3%).
CONCLUSIONS
Maternal exposure to the mixture of air pollutants during pregnancy increases the risk of CHD in offspring, and the effect is much stronger than that of single exposure of various pollutants. PM has the largest weights and the strongest effect in the mixed exposure.
目的
探讨母体暴露于颗粒物 1（PM ）、颗粒物 2.5（PM ）、颗粒物 10（PM ）和 NO 混合空气污染物对后代先天性心脏病（CHD）的风险，并估计上述污染物的排序权重。
方法
纳入 2007 年至 2016 年期间来自广东先天性心脏病注册研究（GRCHD）40 家医疗机构的 6038 例 CHD 患者和 5227 例健康对照。采用 logistic 回归模型估计母体暴露于单一空气污染物对后代 CHD 发生的影响。Spearman 相关系数用于分析各种污染物之间的相关性，分位数 g 计算用于评估空气污染物混合暴露对 CHD 的联合效应和各种污染物的权重。
结果
CHD 组的 PM 、PM 、PM 和 NO 暴露水平明显高于对照组（均<0.01）。PM 、PM 、PM 和 NO 之间的相关系数大于 0.80。PM 、PM 、PM 和 NO 暴露与后代 CHD 风险显著增加相关。这些密切相关的污染物混合暴露对 CHD 的影响比任何单一污染物的暴露要强得多。混合暴露与 CHD 风险之间存在单调递增关系。对于混合暴露的每个分位数增加，CHD 的风险增加 47%（ =1.47，95%：1.34-1.61）。与中晚期妊娠相比，妊娠早期混合暴露对 CHD 的影响更大，但最大的影响是整个孕期的暴露。混合暴露中 PM 的权重最高（81.3%）。
结论
母体在怀孕期间暴露于空气污染物混合物会增加后代患 CHD 的风险，其影响远强于各种污染物的单一暴露。在混合暴露中，PM 具有最大的权重和最强的作用。
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