Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy.
Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Environ Res. 2024 Jun 15;251(Pt 1):118630. doi: 10.1016/j.envres.2024.118630. Epub 2024 Mar 5.
Ambient air pollution has been associated with hypertensive disorders of pregnancy (HDP), but few studies rely on assessment of fine-scale variation in air quality, specific subtypes and multi-pollutant exposures.
To study the impact of long-term exposure to individual and mixture of air pollutants on all and specific subtypes of HDP.
We obtained data from 130,470 liveborn singleton pregnacies in Rome during 2014-2019. Spatiotemporal land-use random-forest models at 1 km spatial resolution assigned to the maternal residential addresses were used to estimate the exposure to particulate matter (PM and PM), nitrogen dioxide (NO), and ozone (O).
For PM PM and NO, there was suggestive evidence of increased risk of preeclampsia (PE, n = 442), but no evidence of increased risk for all subtypes of HDP (n = 2297) and gestational hypertension (GH, n = 1901). For instance, an interquartile range of 7.0 μg/m increase in PM exposure during the first trimester of pregnancy was associated with an odds ratio (OR) of 1.06 (95% confidence interval: 0.81, 1.39) and 1.04 (0.92, 1.17) after adjustment for NO and the corresponding results for a 15.7 μg/m increase in NO after adjustment for PM were 1.11 (0.92, 1.34) for PE and 0.83 (0.76, 0.90) for HDP. Increased risks for HDP and GH were suggested for O in single-pollutant models and for PM after adjustment for NO, but all other associations were stable or attenuated in two-pollutant models.
The results of our study suggest that PM, PM and NO increases the risk of PE and that these effects are robust to adjustment for O while the increased risks for GH and HDP suggested for O attenuated after adjustment for PM or NO. Additional studies are needed to evaluate the effects of source-specific component of PM on subtypes as well as all types of HDP which would help to target preventive actions.
环境空气污染与妊娠高血压疾病（HDP）有关，但很少有研究依赖于空气质量的细粒度变化、特定亚型和多污染物暴露的评估。
研究长期暴露于个体和空气污染物混合物对所有和特定类型的 HDP 的影响。
我们获得了 2014 年至 2019 年期间罗马 130470 例活产单胎妊娠的数据。空间和时间土地利用随机森林模型以 1 公里的空间分辨率分配给母亲的居住地址，用于估计颗粒物（PM 和 PM）、二氧化氮（NO）和臭氧（O）的暴露量。
对于 PM、PM 和 NO，有提示性证据表明子痫前期（PE，n=442）的风险增加，但没有证据表明所有 HDP 亚型（n=2297）和妊娠高血压（GH，n=1901）的风险增加。例如，妊娠早期 PM 暴露增加 7.0μg/m，调整 NO 后 OR 为 1.06（95%置信区间：0.81，1.39），调整 PM 后增加 15.7μg/m 时，PE 的 OR 为 1.11（0.92，1.34），HDP 的 OR 为 0.83（0.76，0.90）。在单污染物模型中，O 与 HDP 和 GH 的风险增加相关，在调整 NO 后，O 与 PM 与 HDP 和 GH 的风险增加相关，但在双污染物模型中，所有其他关联均稳定或减弱。
我们的研究结果表明，PM、PM 和 NO 增加了 PE 的风险，这些影响在调整 O 后是稳健的，而在调整 PM 或 NO 后，O 对 GH 和 HDP 风险增加的影响减弱。需要进一步研究评估 PM 中特定来源成分对亚型以及所有类型 HDP 的影响，这将有助于针对预防措施。
