Graafland Naomi, Essers Esmée, Posthumus Anke, Gootjes Dionne, Ambrós Albert, Steegers Eric, Guxens Mònica
Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
Environ Int. 2023 Jan;171:107730. doi: 10.1016/j.envint.2023.107730. Epub 2023 Jan 3.
Previous literature suggested that noise exposure during pregnancy was not associated with adverse birth outcomes. However, no studies evaluated the association between noise exposure and embryonic and fetal growth, or mutually assessed other urban environmental exposures such as traffic-related air pollution or natural spaces.
We included 7947 pregnant women from the Generation R Study, the Netherlands. We estimated total (road traffic, aircraft, railway, and industry), road traffic, and railway noise at the participants' home addresses during pregnancy using environmental noise maps. We estimated traffic-related air pollution using land-use regression models, greenness within a 300 m buffer using the normalized difference vegetation index, and distance to blue spaces using topographical maps at the home addresses. Embryonic size (crown-rump length) and fetal growth parameters (head circumference, femur length, and estimated fetal weight) were measured by ultrasound at several gestational ages. Information on neonatal anthropometrics at birth (head circumference, length, and weight) and adverse birth outcomes (preterm birth, low birth weight, and small for gestational age) were retrieved from medical records.
Higher total noise exposure during pregnancy was associated with larger crown-rump length (0.07 SDS [95%CI 0.00 to 0.14]). No association was found with fetal growth parameters, neonatal anthropometrics, and adverse birth outcomes. Similar results were observed for road traffic noise exposure, while railway noise exposure was not associated with any of the outcomes. Traffic-related air pollution was not associated with crown-rump length. Total noise exposure mediated 15% of the association between exposure to greenness and smaller crown-rump length. No association was observed between distance to blue spaces and total noise exposure.
Exposure to outdoor residential noise during pregnancy was associated with larger embryonic size. Moreover, a reduction of total noise exposure during pregnancy partially mediated the association between exposure to greenness and smaller embryonic size. Additional research is warranted to confirm and further understand these novel findings.
先前的文献表明，孕期噪声暴露与不良出生结局无关。然而，尚无研究评估噪声暴露与胚胎及胎儿生长之间的关联，也未相互评估其他城市环境暴露因素，如交通相关空气污染或自然空间。
我们纳入了荷兰“R世代研究”中的7947名孕妇。利用环境噪声地图估算孕期参与者家庭住址处的总噪声（道路交通、飞机、铁路和工业噪声）、道路交通噪声和铁路噪声。利用土地利用回归模型估算交通相关空气污染，利用归一化植被指数估算住所地址300米缓冲区内的绿化程度，并利用地形图估算住所到蓝色空间的距离。在几个孕周通过超声测量胚胎大小（头臀长）和胎儿生长参数（头围、股骨长度和估计胎儿体重）。从医疗记录中获取出生时新生儿人体测量学信息（头围、身长和体重）以及不良出生结局（早产、低出生体重和小于胎龄儿）。
孕期较高的总噪声暴露与较大的头臀长相关（0.07标准差[95%置信区间0.00至0.14]）。未发现与胎儿生长参数、新生儿人体测量学指标及不良出生结局存在关联。道路交通噪声暴露的结果相似，而铁路噪声暴露与任何结局均无关联。交通相关空气污染与头臀长无关。总噪声暴露介导了绿化程度暴露与较小头臀长之间15%的关联。未观察到到蓝色空间的距离与总噪声暴露之间存在关联。
孕期暴露于室外居住噪声与较大的胚胎大小相关。此外，孕期总噪声暴露的降低部分介导了绿化程度暴露与较小胚胎大小之间的关联。需要进一步研究以证实并深入理解这些新发现。
