Xu Rongrong, Li Zhigang, Qian Nianfeng, Qian Yan, Wang Zhanshan, Peng Jianhao, Zhu Xiaojing, Guo Chen, Li Xiaoqian, Xu Qiujin, Wei Yongjie
State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, China.
State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China.
Sci Total Environ. 2023 Feb 10;859(Pt 1):160203. doi: 10.1016/j.scitotenv.2022.160203. Epub 2022 Nov 17.
Birth weight is an important indicator of future growth and development for newborns. Few studies investigated the potential effects of air pollutants on macrosomia and their susceptible windows. We included 38,971 singleton full-term births from Beijing HaiDian Maternal and Child Health Hospital between 2014 and 2018, and assessed the associations of air pollutants exposure during preconception and pregnancy with macrosomia as well as the corresponding susceptible windows. The concentrations of air pollutants (PM, PM, SO, NO, CO and O) for participants were calculated by the data from the nearest monitoring stations. Distributed lag models (DLM) incorporating logistic regression models were used to estimate the associations between air pollutants exposure during the 3 months before conception and pregnancy period and the risk of macrosomia, identifying susceptible windows of air pollutants. Weighted quantile sum (WQS) regression was applied to estimate the joint effect of air pollutants. A 10 μg/m increase in PM exposure from 3rd to 8th gestational month was positively associated with the risk of macrosomia, with the strongest effect in the 6th month (OR = 1.010, 95 % CI: 1.002-1.019). For a 10 μg/m increase in SO, the windows of significant exposure were from the 1st preconception month to the 3rd gestational month, with the strongest effect in the 2nd month (OR = 1.030, 95 % CI: 1.010-1.049). We also observed the significant positive associations were in the 5th-8th gestational months for PM, the 8th-9th gestational months for NO and the 3rd-7th gestational months for CO respectively. WQS regression also indicated a positive association between co-exposure to air pollutants and macrosomia. Our results suggest air pollution exposure is associated with increased risk of macrosomia. The windows of exposure for susceptibility to the risk of macrosomia vary between air pollutants. The susceptible exposure windows were middle and late pregnancy for PM, CO and NO, while for SO, early pregnancy is the window of vulnerability. Our findings provide the evidence that air pollution exposure is an independent risk factor for macrosomia and a basis for targeted environment policy.
出生体重是新生儿未来生长发育的重要指标。很少有研究调查空气污染物对巨大儿的潜在影响及其易感窗口期。我们纳入了2014年至2018年期间在北京海淀妇幼保健院出生的38971例单胎足月分娩病例，评估孕前和孕期空气污染物暴露与巨大儿之间的关联以及相应的易感窗口期。根据最近监测站的数据计算参与者的空气污染物（PM、PM、SO、NO、CO和O）浓度。采用纳入逻辑回归模型的分布滞后模型（DLM）来估计孕前3个月和孕期空气污染物暴露与巨大儿风险之间的关联，确定空气污染物的易感窗口期。应用加权分位数和（WQS）回归来估计空气污染物的联合效应。孕3个月至8个月期间PM暴露每增加10 μg/m与巨大儿风险呈正相关，在第6个月时效应最强（OR = 1.010，95%CI：1.002 - 1.019）。对于SO每增加10 μg/m，显著暴露窗口期为孕前第1个月至孕3个月，在第2个月时效应最强（OR = 1.030，95%CI：1.010 - 1.049）。我们还观察到，PM在孕5 - 8个月、NO在孕8 - 9个月、CO在孕3 - 7个月时分别存在显著正相关。WQS回归也表明空气污染物共同暴露与巨大儿之间存在正相关。我们的研究结果表明，空气污染暴露与巨大儿风险增加有关。不同空气污染物导致巨大儿风险的易感暴露窗口期各不相同。PM、CO和NO的易感暴露窗口期为妊娠中晚期，而SO的易感窗口期为妊娠早期。我们的研究结果为空气污染暴露是巨大儿的独立危险因素提供了证据，并为针对性的环境政策提供了依据。
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