孕期空气污染物暴露与早产的相关性研究

Study on the correlation between exposure to air pollutants during pregnancy and preterm birth

摘要

目的 探索孕期空气污染物暴露与早产发生的相关性,为早产的预防提供支持。方法 采用病例对照研究设计,选取2022年1月至2023年12月在眉山市妇幼保健院出生的135例早产儿作为病例组,以同期出生的135例足月儿作为对照组.收集两组孕妇的基本信息和2021年1月至2023年12月各污染物(包括PM_2.5、PM₁₀、SO₂、NO₂、O₃和CO)的日平均浓度,计算孕期各阶段的平均空气污染物浓度,包括整个孕期(孕期平均)、孕前三个月(孕前三月平均)、孕早期(孕12周以内平均)、孕中期(孕13~28周平均)和孕晚期(孕29周以后平均).采用多元逻辑回归分析评估孕期空气污染物暴露与早产的相关性。结果 病例组孕妇在整孕期、孕前三个月、孕早期、孕中期和孕晚期的PM_2.5、PM₁₀、SO₂、NO₂的平均空气污染物暴露水平均显著高于对照组孕妇,t值范围分别为2.52~3.22、2.57~3.09、2.40~2.96、2.44~2.87、2.38~2.78(P＜0.05).整个孕期暴露于较高水平的PM_2.5、SO₂、NO₂与发生早产的风险增加显著相关(P＜0.05),而PM₁₀、O₃和CO对早产发生的影响尚未发现统计学意义(P＞0.05).与孕期平均PM_2.5暴露浓度＜46.0μg/m³组相比,孕期平均PM_2.5暴露浓度在＞69.0μg/m³组的孕妇早产风险显著增加(OR＝1.86,95％CI:1.09~3.17);与孕期平均SO₂暴露浓度＜13.0μg/m³组相比,孕期平均SO₂暴露浓度在＞19.0μg/m³组的孕妇早产风险显著增加(OR＝1.76,95％CI:1.04~2.99);与孕期平均NO₂浓度＜40.0μg/m³组相比,孕期平均NO₂浓度在＞60.0μg/m³组的孕妇早产风险显著增加(OR＝1.82,95％CI:1.08~3.07)。结论 孕期暴露于较高浓度的空气污染物可能是早产发生的重要危险因素之一,提示应关注空气污染,以保护胎儿健康.

Abstract

Objective To explore the association between air pollutant exposure during pregnancy and the occurrence of preterm birth to support the prevention of preterm birth. Methods A case-control study was designed to select 135 preterm infants born in Meishan Maternal and Child Health Hospital from January 2022 to December 2023 as the case group, and 135 full-term infants born during the same period as the control group. The basic information of the two groups of pregnant women and the daily average air pollutant concentrations of each pollutant (including PM_2.5, PM₁₀, SO₂, NO₂, O₃ and CO) from January 2021 to December 2023 were collected, and the average air pollutant concentrations at each stage of pregnancy were calculated, including the whole pregnancy period (pregnancy average), the first trimester of pregnancy (the average of three months before pregnancy), the first trimester (the average of less than 12 weeks of pregnancy), the second trimester (the average of 13~28 weeks of pregnancy) and the third trimester (the average after 29 weeks of pregnancy). Multiple logistic regression analysis was used to evaluate the association between exposure to air pollutants during pregnancy and preterm birth. Results The average exposure levels of PM_2.5, PM₁₀, SO₂ and NO₂ in the whole pregnancy, first trimester, first trimester, second trimester and third trimester of pregnancy were significantly higher than those in the control group (t values ranged from 2.52-3.22, 2.57-3.09, 2.40-2.96, 2.44-2.87, and 2.38-2.78, respectively, P＜0.05). Exposure to higher levels of PM_2.5, SO₂ and NO₂ was significantly associated with an increased risk of preterm birth throughout pregnancy (P＜0.05), while the effects of PM₁₀, O₃ and CO on the occurrence of preterm birth were not statistically significant (P＞0.05). Compared with the average PM_2.5 exposure concentration of ＜46.0μg/m³ during pregnancy, the risk of preterm birth was significantly higher in the ＞69.0μg/m³ group (OR＝1.86, 95%CI: 1.09-3.17). Compared with the ＜13.0μg/m³ group, the risk of preterm birth was significantly increased in the ＞19.0μg/m³ group (OR＝1.76, 95%CI: 1.04-2.99). Compared with the group with an average NO₂ concentration of ＜40.0μg/m³ during pregnancy, the risk of preterm birth was significantly increased in the group with an average NO₂ concentration of ＞60.0μg/m³ (OR＝1.82, 95%CI: 1.08-3.07). Conclusion Exposure to higher concentrations of air pollutants during pregnancy may be one of the important risk factors for preterm birth, suggesting that air pollution should be a concern to protect fetal health.

关键词

空气污染物 / 暴露 / 早产 / 病例对照研究

Key words

air pollutant / exposure / premature birth / case-control study

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