Xu Wei-Ze, Tang Wei-Zhen, Cai Qin-Yu, Pan Yun-Ren, Wang Ying-Xiong, Chen Ya, Lan Xia, Xu Hong-Yu, Zhang Zi-Heng, Deng Bo-Yuan, Wen Li, Wang Lan, Liu Tai-Hang
Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Bioinformatics, School of Basic Medical Sciences, Chongqing Medical University, Chongqing, China.
Ann Med. 2025 Dec;57(1):2534854. doi: 10.1080/07853890.2025.2534854. Epub 2025 Jul 20.
Accelerated industrialization globally has intensified air pollution, but the susceptibility periods for extreme air pollution in twin pregnancies remain undefined.
This study investigated the association between extreme air pollution exposure and preterm birth risk in twin pregnancies. Data on 3623 twin pregnancies in Chongqing from 2017 to 2022 and air pollution readings from 12 monitoring stations were analyzed using distributed lag non-linear quasi-Poisson regression models. Additionally, four extreme air pollution indices were developed to assess the cumulative effects of lagged exposures on preterm birth risk through multivariate logistic regression.
Compared to the lower quartile, the 95th percentile of extreme air pollution exposure showed a positive correlation between concentrations of PM, PM, NO, SO and CO and preterm birth risk in twin pregnancies, with O inversely correlated. Sensitive periods for air pollutants were different. 8-12 and 27-35 gestational weeks were identified for PM; 6-13 and 27-35 gestational weeks were identified for PM; 5-14 and 21-33 gestational weeks were identified for NO; 4-15 and 24-36 gestational weeks were identified for SO; 4-11 and 29-33 gestational weeks were identified for CO. PM, PM, SO and O showed cumulative effects across short and long lags, while CO showed a long-term effect. Notably, NO exhibited a protective effect during all lag periods.
The study highlights gestational windows of 8-11 and 29-33 weeks as highly sensitive to extreme pollution for preterm birth in twin pregnancies, with marked risk increases during 0-3, 0-6 and 0-9-month lag periods.
全球工业化加速加剧了空气污染，但双胎妊娠中极端空气污染的易感期仍不明确。
本研究调查了双胎妊娠中极端空气污染暴露与早产风险之间的关联。使用分布滞后非线性准泊松回归模型分析了2017年至2022年重庆3623例双胎妊娠的数据以及12个监测站的空气污染读数。此外，通过多因素逻辑回归建立了四个极端空气污染指数，以评估滞后暴露对早产风险的累积影响。
与四分位数下限相比，极端空气污染暴露的第95百分位数显示，双胎妊娠中PM、PM、NO、SO和CO的浓度与早产风险呈正相关，而O呈负相关。空气污染物的敏感时期不同。确定PM的敏感时期为妊娠8 - 12周和27 - 35周；PM为妊娠6 - 13周和27 - 35周；NO为妊娠5 - 14周和21 - 33周；SO为妊娠4 - 15周和24 - 36周；CO为妊娠4 - 11周和29 - 33周。PM、PM、SO和O在短期和长期滞后均显示出累积效应，而CO显示出长期效应。值得注意的是，NO在所有滞后时期均表现出保护作用。
该研究强调，妊娠8 - 11周和29 - 33周对双胎妊娠早产的极端污染高度敏感，并在滞后0 - 3个月、0 - 6个月和0 - 9个月期间风险显著增加。
