Department of Pediatrics, Faculty of Medicine, University Hospital Cologne and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany; Department of Epidemiology, NUTRIM School for Translational Research in Metabolism, Maastricht University Medical Centre, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
Department of Pediatrics, St. Marien-Hospital, Hospitalstraße 44, 52353, Düren-Birkesdorf, Germany; Department of Epidemiology, NUTRIM School for Translational Research in Metabolism, Maastricht University Medical Centre, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
Placenta. 2024 Sep 2;154:207-215. doi: 10.1016/j.placenta.2024.07.309. Epub 2024 Jul 26.
This study investigates the association between maternal exposure to particulate matter (PM) and nitric dioxide (NO) during the first, second and third trimester and placental weight and birth weight/placental weight (BW/PW) ratio in twins at birth.
Cross-sectional data of 3340 twins from the East Flanders Prospective Twin Survey was used. Air pollutant exposure was estimated via spatial temporal interpolation. Univariable and multivariable mixed model analyses with a random intercept to account for the relatedness of newborns were conducted for twins with separate placentas. Twin pairs with one placental mass were studied with linear and logistic regression.
In the third trimester, for each 10 μm/m increase in PM or NO placental weight decreased -19.7 g (95%-C.I. -35.1; -4.3) and -17.7 g (95%-C.I. -30.4; -0.5) respectively, in moderate to late preterm twins with separate placentas. Consequently, BW/PW ratio increased with higher air pollution exposure. PM exposure in the last week of pregnancy was associated with a higher odds ratio (OR) of 1.20 (95%-C.I. 1.00; 1.44) for a "small for gestational age placenta" (placental weight <10th percentile). Conversely, first trimester air pollutant exposure was associated with lower ORs of 0.55 (95%-C.I. 0.35; 0.88) and 0.60 (95%-C.I. 0.42; 0.84).
The association of PM and NO on placental weight is trimester-specific, differs for twins with one versus two placentas and is most pronounced in moderate to late preterm twins. Longitudinal studies are needed to better understand the relationship between air pollutant exposure and placental weight evolution across different trimesters.
本研究旨在探讨孕妇在妊娠第一、二、三期间暴露于颗粒物（PM）和二氧化氮（NO）与双胞胎出生时胎盘重量和出生体重/胎盘重量（BW/PW）比值之间的关系。
本研究使用了东佛兰德前瞻性双胞胎研究的 3340 对双胞胎的横断面数据。通过时空插值估计空气污染物暴露情况。对于具有独立胎盘的双胞胎，采用具有随机截距的单变量和多变量混合模型分析来解释新生儿之间的相关性。对于具有一个胎盘质量的双胞胎，采用线性和逻辑回归进行研究。
在妊娠晚期，对于具有独立胎盘的中度至晚期早产儿，PM 或 NO 每增加 10μm/m，胎盘重量分别减少 19.7g（95%CI-35.1；-4.3）和 17.7g（95%CI-30.4；-0.5），BW/PW 比值随着空气污染暴露的增加而增加。妊娠最后一周的 PM 暴露与“小胎盘”（胎盘重量<第 10 百分位数）的比值比（OR）较高相关，为 1.20（95%CI 1.00；1.44）。相反，妊娠早期的空气污染物暴露与较低的 OR 相关，分别为 0.55（95%CI 0.35；0.88）和 0.60（95%CI 0.42；0.84）。
PM 和 NO 对胎盘重量的影响具有特定的妊娠分期，对于具有一个或两个胎盘的双胞胎存在差异，在中度至晚期早产儿中最为明显。需要进行纵向研究，以更好地了解不同妊娠分期空气污染物暴露与胎盘重量变化之间的关系。
