Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy.
Pediatric Nephrology Unit, Regina Margherita Children's Hospital, 10126 Turin, Italy.
Int J Environ Res Public Health. 2023 Jan 16;20(2):1610. doi: 10.3390/ijerph20021610.
Preterm birth (PTB) identifies infants prematurely born <37 weeks/gestation and is one of the main causes of infant mortality. PTB has been linked to air pollution exposure, but its timing is still unclear and neglects the acute nature of delivery and its association with short-term effects. We analyzed 3 years of birth data (2015−2017) in Turin (Italy) and the relationships with proinflammatory chemicals (PM2.5, O3, and NO2) and biological (aeroallergens) pollutants on PTB vs. at-term birth, in the narrow window of a week before delivery. A tailored non-stationary Poisson model correcting for seasonality and possible confounding variables was applied. Relative risk associated with each pollutant was assessed at any time lag between 0 and 7 days prior to delivery. PTB risk was significantly associated with increased levels of both chemical (PM2.5, RR = 1.023 (1.003−1.043), O3, 1.025 (1.001−1.048)) and biological (aeroallergens, RR ~ 1.01 (1.0002−1.016)) pollutants in the week prior to delivery. None of these, except for NO2 (RR = 1.01 (1.002−1.021)), appeared to play any role on at-term delivery. Pollutant-induced acute inflammation eliciting delivery in at-risk pregnancies may represent the pathophysiological link between air pollution and PTB, as testified by the different effects played on PTB revealed. Further studies are needed to better elucidate a possible exposure threshold to prevent PTB.
早产（PTB）是指在妊娠 37 周前出生的婴儿，是婴儿死亡的主要原因之一。PTB 与空气污染暴露有关，但早产的时间仍不清楚，而且忽略了分娩的急性性质及其与短期影响的关系。我们分析了都灵（意大利）3 年的出生数据（2015-2017 年），以及在分娩前一周的狭窄窗口内，与早产与足月分娩相关的促炎化学物质（PM2.5、O3 和 NO2）和生物（气传过敏原）污染物之间的关系。应用了一种针对季节性和可能混杂因素进行校正的定制非平稳泊松模型。在分娩前 0 至 7 天的任何时间滞后，评估了与每种污染物相关的相对风险。在分娩前一周内，PTB 风险与化学污染物（PM2.5，RR=1.023（1.003-1.043）、O3，1.025（1.001-1.048））和生物污染物（气传过敏原，RR~1.01（1.0002-1.016））水平的升高显著相关。除了 NO2（RR=1.01（1.002-1.021））外，这些污染物在分娩前一周都没有发挥作用。在高危妊娠中，污染物引起的急性炎症可能会引发分娩，这表明空气污染和 PTB 之间存在病理生理联系，正如所揭示的 PTB 所产生的不同影响所证明的那样。需要进一步的研究来更好地阐明预防 PTB 的可能暴露阈值。
