Multiple pregnancies and air pollution in moderately polluted cities: Is there an association between air pollution and fetal growth?
Multiple pregnancies and air pollution in moderately polluted cities: Is there an association between air pollution and fetal growth?
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DOI：
10.1016/j.envint.2018.10.015
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发表时间：
2018-12-01
影响因子：
11.8
通讯作者：
Bernard, Nadine
中科院分区：
文献类型：
--
作者：
Mariet, Anne-Sophie;Mauny, Frederic;Bernard, Nadine
背景：多胎妊娠（子宫内多个胎儿同时发育）被系统地排除在空气污染对妊娠结局影响的研究之外。本研究旨在分析多胎妊娠人群中胎儿生长受限（FGR）、小胎龄（SGA）与中度污染城市空气污染暴露之间的关系。方法：包括2005年至2009年在贝桑松市或第戎市区居住并在大学医院分娩的所有多胎妊娠妇女。FGR和SGA来源于医疗记录。室外住宅二氧化氮（NO2）暴露评估使用母亲的地址，考虑50米半径缓冲在以下定义的怀孕期间：每个三个月，整个怀孕和分娩前两个月。进行逻辑回归分析。结果：本研究纳入249例多胎妊娠和506例新生儿。考虑到50 m半径缓冲，整个妊娠期间NO2浓度的中位数为23.1 μ g/m(3)(最小为10.1 μ g/m（3)，最大为46.7 μ g/m(3)）。无论妊娠期如何，NO2与SGA均无相关性（比值比（OR）范围为0.78 ~ 0.88）。在FGR方面，全孕期NO2暴露增加10 μ g/m(3)的OR为1.52（95%可信区间（CI）： 1.02-2.26）。在不同的怀孕期间，二氧化氮暴露也观察到类似的结果。结论：这些结果与多胎妊娠中二氧化氮与胎儿生长之间的关系一致，暴露量大多低于欧洲立法规定的阈值。
Background: Multiple pregnancies (where more than one fetus develops simultaneously in the womb) are systematically excluded from studies of the impact of air pollution on pregnancy outcomes. This study aims to analyze, in a population of multiple pregnancies, the relationship between fetal growth restriction (FGR), small for gestational age (SGA) and exposure to air pollution in moderately polluted cities.Methods: All women with multiple pregnancies living in the city of Besancon or in the urban area of Dijon and who delivered at a university hospital between 2005 and 2009 were included. FGR and SGA were obtained from medical records. Outdoor residential nitrogen dioxide (NO2) exposure was assessed using the mother's address, considering a 50 m radius buffer over the following defined pregnancy periods: each trimester, entire pregnancy and two months before delivery. Logistic regression analyses were performed.Results: This study included 249 multiple pregnancies with 506 newborns. The median of NO2 concentration considering a 50 m radius buffer during entire pregnancy was 23.1 mu g/m(3) (minimum at 10.1 mu g/m(3) and maximum at 46.7 mu g/m(3)). No association was observed between NO2 and SGA whatever the pregnancy period (the odds ratio (OR) range 0.78 to 0.88). Regarding FGR, the OR associated with an increase of 10 mu g/m(3) of NO2 exposure during entire pregnancy was 1.52 (95% Confidence Interval (CI): 1.02-2.26). Similar results were observed for NO2 exposure during the various pregnancy periods.Conclusions: These results are in line with an association between NO2 and fetal growth in multiple pregnancies for an exposure mostly below the threshold set out in European legislation.