Medical School of Yan'an University, Yan'an, China.
Front Public Health. 2024 Jul 25;12:1415028. doi: 10.3389/fpubh.2024.1415028. eCollection 2024.
To investigate the association between exposure to atmospheric pollutants and preterm birth in a river valley-type city and its critical exposure windows.
A retrospective cohort study was used to collect data from the medical records of preterm and full-term deliveries in two hospitals in urban areas of a typical river valley-type city from January 2018 to December 2019. A total of 7,288 cases were included in the study with general information such as pregnancy times, the number of cesarean sections, occupation, season of conception and regularity of the menstrual cycle. And confounding factors affecting preterm birth were inferred using the chi-square test. The effects of exposure to each pollutant, including particulate matter 2.5 (PM), particulate matter 10 (PM), nitrogen dioxide (NO), sulfur dioxide (SO), carbon monoxide (CO) and ozone (O), during pregnancy on preterm birth and the main exposure windows were explored by establishing a logistic regression model with pollutants introduced as continuous variables.
Maternal age, pregnancy times, number of births, number of cesarean sections, season of conception, complications diseases, comorbidities diseases, hypertension disorder of pregnancy and neonatal low birth weight of the newborn were significantly different between preterm and term pregnant women. Logistic regression analysis after adjusting for the above confounders showed that the risk of preterm birth increases by 0.9, 0.6, 2.4% in T and by 1.0, 0.9, 2.5% in T for each 10 μg/m increase in PM, PM NO concentrations, respectively. The risk of preterm birth increases by 4.3% in T for each 10 μg/m increase in SO concentrations. The risk of preterm birth increases by 123.5% in T and increases by 188.5% in T for each 10 mg/m increase in CO concentrations.
Maternal exposure to PM, PM NO, CO was associated with increased risk on preterm birth in mid-pregnancy (T) and late pregnancy (T), SO exposure was associated with increased risk on preterm birth in mid-pregnancy (T).
探讨河谷型城市大气污染物暴露与早产的关系及其关键暴露窗口。
采用回顾性队列研究,收集 2018 年 1 月至 2019 年 12 月在某河谷型城市城区两家医院分娩的早产儿和足月儿的病历资料。共纳入 7288 例,包括妊娠次数、剖宫产次数、职业、受孕季节、月经周期是否规律等一般信息。采用卡方检验推断影响早产的混杂因素。采用 logistic 回归模型,将污染物作为连续变量,建立模型探讨妊娠期间暴露于各污染物(PM2.5、PM10、NO2、SO2、CO 和 O3)对早产的影响及其主要暴露窗口。
早产组和足月组孕妇的年龄、妊娠次数、产次、剖宫产次数、受孕季节、并发症、合并症、妊娠期高血压疾病、新生儿低出生体重差异均有统计学意义。调整上述混杂因素后,logistic 回归分析显示,PM、PM10、NO2 浓度每增加 10μg/m3,早产风险分别增加 0.9%、0.6%、2.4%;SO2 浓度每增加 10μg/m3,早产风险增加 4.3%;CO 浓度每增加 10mg/m3,早产风险增加 123.5%;T 期增加 188.5%。
母亲在妊娠中期(T)和晚期(T)暴露于 PM、PM10、CO 与早产风险增加相关,暴露于 SO2 与早产风险增加相关。