Sun Wen, Dong Qingqing, Zhang Yingying, Wang Hui, Wang Youqiang, Yuan Wenjie, Wang Leyao, Shi Xianhong, Feng Yuhong, Wang Haiwei, Wang Xiaodan, Ren Yingbin, Wang Lihong, Lei Lijian, Song Wenxia
Department of Epidemiology, School of Public Health, Shanxi Medical University, Shanxi Key Laboratory of Environmental Health Impairment and Prevention, NHC Key Laboratory of Pneumoconiosis, MOE Key Laboratory of Coal Environmental, Taiyuan, Shanxi, China.
Changzhi Maternal and Child Health Care Hospital, Changzhi City Key Laboratory of Birth Defect Prevention and Control, Changzhi, Shanxi, China.
Front Public Health. 2025 Apr 9;13:1562461. doi: 10.3389/fpubh.2025.1562461. eCollection 2025.
As global fertility rates decline, exploring the root causes of birth defects (BDs) becomes urgent. Air pollution, with its ability to penetrate the placental barrier as exogenous toxins, has garnered notable attention in this regard.
BD data was collected from five hospitals in Changzhi City birth from 2019 to 2021, air quality data originated from hourly observations at five monitoring stations within the city. Using the distributed lag non-linear model (DLNM), the study aimed to determine the non-linear exposure-lag-effect relationship, evaluating the delayed impact of weekly air pollution on fetal BD risk. During the period under study, the prevalence of BDs was 19.95‰.
Our findings indicate that exposure to air pollutants during early and mid-pregnancy elevated the risk of BDs. Specifically, for each 10 μg/m increase of SO, NO, PM, PM, O, and CO, the risk of congenital heart defects (CHDs) increased. Peaking at specific gestational weeks: SO at week 17, NO at week 23, PM at week 21, PM at week 16, O at week 8, and CO at week 40. Additionally, a rise of 10 μg/m in PM during weeks 4-10 of gestation significantly elevated the risk of polydactyly, peaking at week 6. Increases in PM2.5 and CO were associated with an elevated risk of external ear malformations, peaking at week 18 and week 19, respectively. Furthermore, higher concentrations of NO and NO increased the risk of syndactyly, peaking at week 0 for both pollutants. Finally, increments of 10 μg/m in NO, NO, NO, and PM were all significantly associated with an increased risk of cleft lip and/or palate, peaking at week 3 for NO, NO, NO, and PM. Exposure to air pollutants elevates BD risk, with critical periods during the first and second trimesters. The association between different pollutants and the classification of BDs also varies.
Exposure to pollutants during pregnancy increases the risk of birth defects in newborns, especially SO, PM, PM and O. In light of these findings, we recommend that, while overall regional air quality improvements remain essential, specific targeted measures should be implemented for pregnant women, who represent a particularly vulnerable population. These targeted recommendations not only aim to reduce exposure risks for pregnant women and their fetuses but also offer practical insights for public health policy and interventions.
随着全球生育率下降，探究出生缺陷（BDs）的根本原因变得刻不容缓。空气污染作为外源性毒素能够穿透胎盘屏障，在这方面已引起显著关注。
收集了长治市五家医院2019年至2021年出生的BD数据，空气质量数据源自该市五个监测站的每小时观测值。本研究采用分布滞后非线性模型（DLNM）来确定非线性暴露-滞后-效应关系，评估每周空气污染对胎儿BD风险的延迟影响。在研究期间，BD的患病率为19.95‰。
我们的研究结果表明，孕早期和孕中期接触空气污染物会增加BD的风险。具体而言，SO、NO、PM、PM、O和CO每增加10μg/m，先天性心脏病（CHDs）的风险就会增加。在特定孕周达到峰值：SO在第17周，NO在第23周，PM在第21周，PM在第16周，O在第8周，CO在第40周。此外，妊娠第4至10周期间PM每增加10μg/m，多指畸形的风险显著增加，在第6周达到峰值。PM2.5和CO的增加分别与外耳畸形风险升高相关，分别在第18周和第19周达到峰值。此外，较高浓度的NO和NO增加并指畸形的风险，两种污染物均在第0周达到峰值。最后，NO、NO、NO和PM每增加10μg/m均与唇裂和/或腭裂风险增加显著相关，NO、NO、NO和PM分别在第3周达到峰值。接触空气污染物会增加BD风险，在孕早期和孕中期为关键时期。不同污染物与BD分类之间的关联也有所不同。
孕期接触污染物会增加新生儿出生缺陷的风险，尤其是SO、PM、PM和O。鉴于这些发现，我们建议，虽然整体区域空气质量改善仍然至关重要，但应为孕妇这一特别脆弱的人群实施具体的针对性措施。这些针对性建议不仅旨在降低孕妇及其胎儿的接触风险，还为公共卫生政策和干预措施提供了实际见解。
