The association between fine particulate matter exposure during pregnancy and preterm birth: a meta-analysis.
The association between fine particulate matter exposure during pregnancy and preterm birth: a meta-analysis.
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怀孕期间细颗粒物暴露与早产之间的关联：荟萃分析
DOI：
10.1186/s12884-015-0738-2
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发表时间：
2015-11-18
影响因子：
3.1
通讯作者：
Liu T
中科院分区：
文献类型：
--
作者：
Sun X;Luo X;Zhao C;Chung Ng RW;Lim CE;Zhang B;Liu T
背景尽管之前的几项研究已经评估了妊娠期间细颗粒物（PM2.5）暴露与早产的关系，但结果并不一致，仍然存在争议。本荟萃分析的目的是定量总结孕妇PM2. 5暴露与早产之间的关联，并进一步探讨这种关联的异质性来源。方法我们在MEDLINE、PUBMED和Embase数据库以及中国生物医学和万方数据库中检索了2014年12月之前发表的所有关于妊娠期PM2. 5暴露与早产之间关联的研究。早产与PM2.5暴露量每增加10 μg/m3相关的合并OR通过随机效应模型（对于具有显著异质性的研究）或固定效应模型（对于无显著异质性的研究）计算。13项研究中，整个妊娠期PM2.5暴露（每10 μg/m3增量）与早产的合并OR为1.13（95%CI = 1.03-1.24），具有显著异质性（Q = 80.51，p < 0.001）。孕早期、孕中期和孕晚期PM2.5暴露的合并OR分别为1.08（95%CI = 0.92-1.26）、1.09（95%CI = 0.82-1.44）和1.08（95%CI = 0.99-1.17）。在个体、半个体和区域水平上评估PM2.5暴露的研究中，相应的PM2.5效应的meta估计值分别为1.11（95%CI = 0.89-1.37）、1.14（95%CI = 0.97-1.35）和1.07（95%CI = 0.94-1.23）。此外，在回顾性研究中发现了PM2.5暴露的显著荟萃估计值（OR = 1.10，95% CI = 1.01-1.21），前瞻性研究（OR = 1.42，95% CI = 1.08-1.85），以及在美国进行的研究结论孕妇孕期PM2.5暴露可能增加早产风险，但研究间存在显著异质性。暴露评估方法、研究设计和研究环境可能是异质性的重要来源，在未来的荟萃分析中应予以考虑。
BackgroundAlthough several previous studies have assessed the association of fine particulate matter (PM2.5) exposure during pregnancy with preterm birth, the results have been inconsistent and remain controversial. This meta-analysis aims to quantitatively summarize the association between maternal PM2.5exposure and preterm birth and to further explore the sources of heterogeneity in findings on this association.MethodsWe searched for all studies published before December 2014 on the association between PM2.5exposure during pregnancy and preterm birth in the MEDLINE, PUBMED and Embase databases as well as the China Biological Medicine and Wanfang databases. A pooled OR for preterm birth in association with each 10 μg/m3increase in PM2.5exposure was calculated by a random-effects model (for studies with significant heterogeneity) or a fixed-effects model (for studies without significant heterogeneity).ResultsA total of 18 studies were included in this analysis. The pooled OR for PM2.5exposure (per 10 μg/m3increment) during the entire pregnancy on preterm birth was 1.13 (95 % CI = 1.03–1.24) in 13 studies with a significant heterogeneity (Q = 80.51,p< 0.001). The pooled ORs of PM2.5exposure in the first, second and third trimester were 1.08 (95 % CI = 0.92–1.26), 1.09 (95 % CI = 0.82–1.44) and 1.08 (95 % CI = 0.99–1.17), respectively. The corresponding meta-estimates of PM2.5effects in studies assessing PM2.5exposure at individual, semi-individual and regional level were 1.11 (95 % CI = 0.89–1.37), 1.14 (95 % CI = 0.97–1.35) and 1.07 (95 % CI = 0.94–1.23). In addition, significant meta-estimates of PM2.5exposures were found in retrospective studies (OR = 1.10, 95 % CI = 1.01–1.21), prospective studies (OR = 1.42, 95 % CI = 1.08–1.85), and studies conducted in the USA (OR = 1.16, 95 % CI = 1.05–1.29).ConclusionsMaternal PM2.5exposure during pregnancy may increase the risk of preterm birth,but significant heterogeneity was found between studies. Exposure assessment methods, study designs and study settings might be important sources of heterogeneity, and should be taken into account in future meta-analyses.