Associations of maternal ozone exposures during pregnancy with maternal blood pressure and risk of hypertensive disorders of pregnancy: A birth cohort study in Guangzhou, China
Associations of maternal ozone exposures during pregnancy with maternal blood pressure and risk of hypertensive disorders of pregnancy: A birth cohort study in Guangzhou, China
复制标题
孕期孕妇臭氧暴露与孕妇血压和妊娠期高血压疾病风险的关联：中国广州的出生队列研究
DOI：
10.1016/j.envres.2020.109207
复制
发表时间：
2020-04-01
影响因子：
8.3
通讯作者：
Liu, Tao
中科院分区：
文献类型：
--
作者：
Cao, Wenjun;Dong, Moran;Liu, Tao
虽然研究已经评估了孕妇在怀孕期间接触臭氧（O-3）与血压和妊娠高血压疾病（HDP）风险的关系，但结果并不一致。此外，在中国，环境中的O-3浓度持续增加，没有进行研究。本研究的目的是评估母亲在怀孕期间暴露于O-3对HDP风险、收缩压（SBP）、舒张压（DBP）和脉压（PP）的影响。所有参与者均来自中国广州进行的产前环境与后代健康的前瞻性出生队列研究。时空土地利用回归模型被用来估计个人每月的空气污染暴露从怀孕前三个月到分娩日期。HDP、SBP、DBP和PP的信息来自母体病历。采用Logistic回归模型和混合线性模型分别估计母亲接触O-3与HDP和血压（SBP、DBP和PP）风险的关系。我们发现母亲在怀孕前第三个月（OR = 1.31，95%CI：1.07，1.60）和第二个月（OR = 1.25，95%CI：1.02，1.51）暴露于O-3与HDP的风险显著相关。在孕前两个月和孕早期，观察到O-3暴露与SBP、DBP和PP显著正相关。O3暴露对收缩压、舒张压和脉压的影响高峰分别出现在妊娠第2个月（β = 1.07 mmHg，95%CI：0.84，1.31 mmHg），妊娠前1个月（β = 0.40 mmHg，95%CI：0.21，0.50 mmHg）和怀孕第二个月（β = 0.78 mmHg，95%CI：0.59，0.97 mmHg）。研究结果提示，孕妇暴露于O-3与血压和HDP风险呈正相关，孕前3个月至孕早期可能是暴露的关键窗口期。
Although studies have assessed the associations of maternal exposure to ozone (O-3) during pregnancy with blood pressure and the risk of hypertensive disorders of pregnancy (HDP), the results were inconsistent. Furthermore, no studies have been conducted in China where the ambient O-3 concentration continuedly increased. The present study aimed to estimate the effects of maternal exposure to O-3 during pregnancy on the HDP risk, systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP). All participants of pregnant women were selected from the prospective birth cohort study on Prenatal Environments and Offspring Health conducted in Guangzhou, China. A spatiotemporal land-use-regression model was used to estimate individual monthly air pollution exposure from three months before pregnancy to childbirth date. Information on HDP, SBP, DBP and PP was obtained from maternal medical records. A Logistic regression model and a mixed linear model were used to estimate the associations of maternal exposure to O-3 with the risk of HDP and blood pressure (SBP, DBP and PP), respectively. We found significant associations of maternal exposure to O-3 during the third (OR = 1.31, 95%CI: 1.07, 1.60) and the second month (OR = 1.25, 95%CI: 1.02, 1.51) before pregnancy with the risk of HDP. Observed significantly positive associations of O-3 exposures with SBP, DBP and PP during the two months before pregnancy and during the early pregnancy. The peak effects of O3 exposure on SBP, DBP and PP were respectively observed during the second month of pregnancy (beta = 1.07 mmHg, 95%CI: 0.84, 1.31 mmHg), the first month before pregnancy (beta = 0.40 mmHg, 95%CI: 0.21, 0.50 mmHg) and the second month of pregnancy (beta = 0.78 mmHg, 95%CI: 0.59, 0.97 mmHg). Our results suggest that maternal exposure to O-3 were positively associated with blood pressure and the risk of HDP, and the period from three months before pregnancy to the first trimester might be the critical exposure window.