Ambient air pollution and adverse birth outcomes: Differences by maternal comorbidities
Ambient air pollution and adverse birth outcomes: Differences by maternal comorbidities
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DOI：
10.1016/j.envres.2016.04.026
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发表时间：
2016-07-01
影响因子：
8.3
通讯作者：
Walker, Mark
中科院分区：
文献类型：
--
作者：
Lavigne, Eric;Yasseen, Abdool S., III;Walker, Mark
背景资料：产前暴露于环境空气污染与不良的出生结局有关，但母体合并症的潜在改变作用仍未得到充分研究。我们的目的是调查产前空气污染暴露和出生结果之间的关联是否因母体合并症而不同。方法：2005年至2012年，加拿大安大略省共确定了818，400例单胎活产。我们分配暴露于细颗粒物（PM2.5），二氧化氮（NO2）和臭氧（03）的孕妇住所在怀孕期间。我们评估了母体合并症的潜在效应改变（即哮喘、高血压、糖尿病、心脏病、妊娠期糖尿病和先兆子痫）对产前空气污染与早产、足月低出生体重和小于胎龄儿之间关系的研究。PM2.5的四分位距（IQR）增加在整个怀孕期间，NO2（9 ppb）和03（5 ppb）与4%的早产几率分别增加8.4%（95% CI：5.5-10.3%）和2%（95% CI：0.5-4.1%）。增长10.6%（95% CI：0.2-2.1%）和23.8%（95%CI：5.5-44.8%），而早产的几率增加了3.8%，（95%CI：2.2-5.4%）和6.5%（95%CI：3.7-8.4%）（P-int < 0.01）。妊娠期间暴露于PM2.5导致早产的几率增加，先兆子痫妇女（8.3%，95% CI：0.8-16.4%）高于无先兆子痫妇女（3.6%，95% CI：1.8-53%）（P-int=0.04）。与非哮喘妇女（2.0%，95%CI：0.1-3.5%）相比，发现哮喘妇女在怀孕期间暴露于03（12.0%，95%CI：3.5-21.1%）的早产几率增加更大（P-int < 0.01）。我们没有发现统计学上显着的影响修改其他outcomeinvestigated.Conclusions：这项研究的结果表明，环境空气污染与早产的关联更强的妇女与预先存在的糖尿病，哮喘和先兆子痫。皇冠版权所有（C）2016由Elsevier Inc.
Background: Prenatal exposure to ambient air pollution has been associated with adverse birth outcomes, but the potential modifying effect of maternal comorbidities remains understudied. Our objective was to investigate whether associations between prenatal air pollution exposures and birth outcomes differ by maternal comorbidities.Methods: A total of 818,400 singleton live births were identified in the province of Ontario, Canada from 2005 to 2012. We assigned exposures to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (03) to maternal residences during pregnancy. We evaluated potential effect modification by maternal comorbidities (i.e. asthma, hypertension, pre-existing diabetes mellitus, heart disease, gestational diabetes and preeclampsia) on the associations between prenatal air pollution and preterm birth, term low birth weight and small for gestational age.Results: Interquartile range (IQR) increases in PM2.5 (2 mu g/m(3)), NO2 (9 ppb) and 03 (5 ppb) over the entire pregnancy were associated with a 4% (95% CI: 2.4-5.6%), 8.4% (95% CI: 5.5-10.3%) and 2% (95% CI: 0.5-4.1%) increase in the odds of preterm birth, respectively. Increases of 10.6% (95% CI: 0.2-2.1%) and 23.8% (95% CI: 5.5-44.8%) in the odds of preterm birth were observed among women with pre-existing diabetes while the increases were of 3.8% (95% CI: 2.2-5.4%) and 6.5% (95% CI: 3.7-8.4%) among women without this condition for pregnancy exposure to PM2.5 and NO2, respectively (P-int < 0.01). The increase in the odds of preterm birth for exposure to PM2.5 during pregnancy was higher among women with preeclampsia (8.3%, 95% CI: 0.8-16.4%) than among women without (3.6%, 95% CI: 1.8-53%) (P-int=0.04). A stronger increase in the odds of preterm birth was found for exposure to 03 during pregnancy among asthmatic women (12.0%, 95% CI: 3.5-21.1%) compared to non-asthmatic women (2.0%, 95% CI: 0.1-3.5%) (P-int < 0.01). We did not find statistically significant effect modification for the other outcomes investigated.Conclusions: Findings of this study suggest that associations of ambient air pollution with preterm birth are stronger among women with pre-existing diabetes, asthma, and preeclampsia. Crown Copyright (C) 2016 Published by Elsevier Inc.