Folic Acid Supplementation and the Association between Maternal Airborne Particulate Matter Exposure and Preterm Delivery: A National Birth Cohort Study in China.
Folic Acid Supplementation and the Association between Maternal Airborne Particulate Matter Exposure and Preterm Delivery: A National Birth Cohort Study in China.
复制标题
叶酸补充剂以及母亲空气颗粒物暴露与早产之间的关联：中国的全国出生队列研究
DOI：
10.1289/ehp6386
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发表时间：
2020-12
影响因子：
10.4
通讯作者：
Ma X
中科院分区：
文献类型：
--
作者：
Li Q;Wang YY;Guo Y;Zhou H;Wang X;Wang QM;Shen HP;Zhang YP;Yan DH;Li S;Chen G;Lin L;He Y;Yang Y;Peng ZQ;Wang HJ;Ma X
叶酸(FA)补充对母体颗粒物(PM)暴露和早产(PTD)之间关系的潜在影响尚未进行研究。我们研究了补充FA是否可以降低母亲在怀孕期间暴露于环境空气中的PM所导致的PTD风险。2014年，在一项涵盖大陆31个省份中国的30个省份的队列研究中，对1229,556名汉族初产妇进行了跟踪调查，直到分娩。我们收集了他们补充FA和妊娠结局的信息，并使用基于卫星遥感的模型估计了每个参与者暴露于PM的直径为()、()和()。在控制了个体特征后，使用COX比例风险回归模型来检验补充FA和PM暴露之间的交互作用。怀孕前开始使用FA的参与者(38.1%)患PTD的风险比没有使用未孕FA的女性低23%[风险比(95%CI：0.76，0.78)]。PM浓度最高四分位数的参与者患PTD的风险[(95%CI：1.26，1.32)，1.52(95%CI：1.46，1.58)，1.22(95%CI：1.17，1.27)]高于PM浓度最低四分位数暴露者。在怀孕前开始使用FA的妇女[(95%CI：1.08，1.10)在两次暴露中]与未使用未孕FA的妇女[(95%CI：1.11，1.13)在两次暴露中]相比，估计与增加的相关性显著降低。相应的关联性也显著低于妊娠前FA的增加[(95%CI：1.02，1.03)与未怀孕FA的1.04(95%CI：1.03，1.04)]。我们的发现需要在其他人群中得到证实，但他们表明，在汉族初产妇怀孕期间开始补充FA可能会降低与PM暴露相关的PTD的风险。Https://doi.org/10.1289/EHP6386
Potential modification of the association between maternal particulate matter (PM) exposure and preterm delivery (PTD) by folic acid (FA) supplementation has not been studied. We examined whether FA supplementation could reduce the risk of PTD associated with maternal exposure to PM in ambient air during pregnancy. In a cohort study covering 30 of the 31 provinces of mainland China in 2014, 1,229,556 primiparas of Han ethnicity were followed until labor. We collected information on their FA supplementation and pregnancy outcomes and estimated each participant’s exposure to PM with diameters of (), (), and () using satellite remote-sensing based models. Cox proportional hazard regression models were used to examine interactions between FA supplementation and PM exposures, after controlling for individual characteristics. Participants who initiated FA prior to pregnancy (38.1%) had a 23% [hazard ratio (95% CI: 0.76, 0.78)] lower risk of PTD than women who did not use preconception FA. Participants with PM concentrations in the highest quartile had a higher risk of PTD [ (95% CI: 1.26, 1.32) for , 1.52 (95% CI: 1.46, 1.58) for , and 1.22 (95% CI: 1.17, 1.27) for ] than those with exposures in the lowest PM quartiles. Estimated associations with a increase in and were significantly lower among women who initiated FA prior to pregnancy [ (95% CI: 1.08, 1.10) for both exposures] than among women who did not use preconception FA [ (95% CI: 1.11, 1.13) for both exposures; ]. The corresponding association was also significantly lower for a increase in [ (95% CI: 1.02, 1.03) for FA before pregnancy vs. 1.04 (95% CI: 1.03, 1.04) for no preconception FA; ]. Our findings require confirmation in other populations, but they suggest that initiating FA supplementation prior to pregnancy may lessen the risk of PTD associated with PM exposure during pregnancy among primiparas of Han ethnicity. https://doi.org/10.1289/EHP6386