Zhou Shuang, Li Tiantian, Han Na, Zhang Kai, Chen Gongbo, Zhang Yi, Li Qin, Ji Yuelong, Liu Jue, Wang Hui, Hu Jianlin, Liu Ting, Raat Hein, Guo Yuming, Wang Haijun
Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, 100191, Beijing, China.
China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, 100021, Beijing, China.
J Expo Sci Environ Epidemiol. 2025 May;35(3):502-510. doi: 10.1038/s41370-024-00658-x. Epub 2024 Mar 26.
Prenatal fine particulate matter (PM) constituents exposure and reduced fetal growth may be risk factors for accelerated growth in early childhood, an important indicator for lifelong health.
The study investigated whether the joint effects are present between PM constituents and reduced fetal growth.
The study was embedded in a birth cohort in China, including 5424 mother-child pairs. Prenatal PM and its constituents' [organic carbon (OC), elementary carbon (EC), ammonium (NH), nitrate (NO), and sulfate (SO)] concentrations were estimated based on maternal residential addresses. Fetal growth was evaluated by fetal growth trajectory in utero and preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). Children's accelerated growth was defined as body mass index (BMI) Z-score change of >0.67 between birth and 3 years. Generalized logistic regression was used to analyze the effects of prenatal PM constituents exposure and fetal growth on children's accelerated growth. Joint effect was tested on multiplicative scale and additive scale with the relative excess risk due to interaction (RERI).
Children with lower fetal growth trajectory, PTB, LBW, and SGA had increased odds of children's accelerated growth, with odds ratios (ORs) ranging from 1.704 to 11.605. Compared with lower exposure (≤median), higher exposure (>median) of PM, OC, and SO were significantly associated with increased odds of children's accelerated growth, varying in ORs from 1.163 to 1.478. Prenatal exposure to OC had joint effects with lower fetal growth on children's accelerated growth. We observed that the interaction was statistically significant on an additive scale in OC and lower fetal growth trajectory (RERI: 0.497, 95% CI: 0.033,0.962).
Fine particulate matter (PM) is a huge threat to human health worldwide, causing 6.7 million death globally in 2019. According to the theory of DOHaD, prenatal PM exposure could influence early childhood growth, which is important for lifelong health. We found that prenatal exposure to PM, OC, and SO was associated with higher risk of accelerated childhood growth in the first 3 years. More importantly, reduced fetal growth moderated these associations. Our findings highlight the need for policies and interventions on PM constituents to improve lifelong health, especially for those vulnerable populations with reduced fetal growth.
产前接触细颗粒物（PM）成分以及胎儿生长受限可能是儿童早期生长加速的风险因素，而儿童早期生长加速是终身健康的一项重要指标。
本研究调查了PM成分与胎儿生长受限之间是否存在联合效应。
本研究纳入了中国一个出生队列中的5424对母婴。根据母亲的居住地址估算产前PM及其成分[有机碳（OC）、元素碳（EC）、铵（NH）、硝酸盐（NO）和硫酸盐（SO）]的浓度。通过子宫内胎儿生长轨迹以及早产（PTB）、低出生体重（LBW）和小于胎龄儿（SGA）来评估胎儿生长情况。儿童生长加速定义为出生至3岁期间体重指数（BMI）Z评分变化>0.67。采用广义逻辑回归分析产前PM成分暴露和胎儿生长对儿童生长加速的影响。通过交互作用相对超额危险度（RERI）在相乘尺度和相加尺度上检验联合效应。
胎儿生长轨迹较低、早产、低出生体重和小于胎龄儿的儿童出现生长加速的几率增加，比值比（OR）范围为1.704至11.605。与较低暴露水平（≤中位数）相比，较高暴露水平（>中位数）的PM、OC和SO与儿童生长加速几率增加显著相关，OR范围为1.163至1.478。产前接触OC与胎儿生长受限对儿童生长加速存在联合效应。我们观察到，在相加尺度上，OC与较低胎儿生长轨迹之间的交互作用具有统计学意义（RERI：0.497，95%置信区间：0.033，0.962）。
细颗粒物（PM）在全球范围内对人类健康构成巨大威胁，2019年在全球导致670万人死亡。根据健康与发展的发育起源理论，产前接触PM可能会影响儿童早期生长，这对终身健康至关重要。我们发现，产前接触PM、OC和SO与儿童在出生后前3年生长加速的较高风险相关。更重要的是，胎儿生长受限会使这些关联减弱。我们的研究结果凸显了针对PM成分制定政策和采取干预措施以改善终身健康的必要性，特别是对于那些胎儿生长受限的脆弱人群。
