Air pollution exposure and preeclampsia among US women with and without asthma.
Air pollution exposure and preeclampsia among US women with and without asthma.
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DOI：
10.1016/j.envres.2016.04.004
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发表时间：
2016-07
影响因子：
8.3
通讯作者：
Grantz KL
中科院分区：
文献类型：
--
作者：
Mendola P;Wallace M;Liu D;Robledo C;Mӓnnistӧ T;Grantz KL
母体哮喘和空气污染物与先兆子痫独立相关，但很少一起研究。我们的目的是综合评估先兆子痫的风险的基础上，母亲哮喘和空气污染物的相互作用。先兆子痫和哮喘的诊断、人口统计学和临床数据来自210,508例单胎分娩的电子病历。修改后的社区多尺度空气质量模型估计了孕前、妊娠早期和中期以及整个妊娠期暴露于以下物质的情况：颗粒物（PM）< 2.5和< 10 µm，臭氧，氮氧化物（NOx），二氧化硫（SO2）和一氧化碳（CO）; PM2.5成分;挥发性有机化合物（VOC）和多环芳烃（PAH）。通过标准污染物的四分位数间距和多环芳烃和挥发性有机化合物的高暴露量（≥ 75百分位数），计算了先兆子痫的哮喘-污染物相互作用校正的相对危险度（RR）和95%置信区间（CI）。与非哮喘患者相比，哮喘患者与早期妊娠NOx和SO2以及整个妊娠元素碳（EC）暴露相关的风险更高，但只有EC显著增加风险（RR=1.11，CI：1.03-1.21）。哮喘患者也有10%的风险增加与妊娠中期CO。显着的相互作用，观察到几乎所有的挥发性有机化合物和哮喘患者有较高的风险在所有的时间窗口苯，二甲苯，间二甲苯，邻二甲苯，对二甲苯和甲苯，而大多数多环芳烃没有增加风险。
Maternal asthma and air pollutants have been independently associated with preeclampsia but rarely studied together. Our objective was to comprehensively evaluate preeclampsia risk based on the interaction of maternal asthma and air pollutants. Preeclampsia and asthma diagnoses, demographic and clinical data came from electronic medical records for 210,508 singleton deliveries. Modified Community Multiscale Air Quality models estimated preconception, first and second trimester and whole pregnancy exposure to: particulate matter (PM) < 2.5 and < 10 µm, ozone, nitrogen oxides (NOx), sulfur dioxide (SO2) and carbon monoxide (CO); PM2.5 constituents; volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs). Asthma-pollutant interaction adjusted relative risks (RR) and 95% confidence intervals (CI) for preeclampsia were calculated by interquartile range for criteria pollutants and high exposure (≥ 75th percentile) for PAHs and VOCs. Asthmatics had higher risk associated with first trimester NOx and SO2 and whole pregnancy elemental carbon (EC) exposure than non-asthmatics, but only EC significantly increased risk (RR=1.11, CI:1.03–1.21). Asthmatics also had a 10% increased risk associated with second trimester CO. Significant interactions were observed for nearly all VOCs and asthmatics had higher risk during all time windows for benzene, ethylbenzene, m-xylene, o-xylene, p-xylene and toluene while most PAHs did not increase risk.