Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City.
Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City.
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DOI：
10.1097/ede.0000000000000349
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Wellenius GA
中科院分区：
文献类型：
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作者：
Savitz DA;Elston B;Bobb JF;Clougherty JE;Dominici F;Ito K;Johnson S;McAlexander T;Ross Z;Shmool JL;Matte TD;Wellenius GA
以前的研究表明，细颗粒物空气污染（PM2.5）和二氧化氮（NO2）与妊娠期高血压疾病的发展之间可能存在关联，但影响范围很小，方法学上的弱点排除了明确的结论。我们将2008-2010年纽约市的出生证明与医院出院诊断和基于母亲地址的空气污染暴露估计联系起来。纽约市社区空气调查提供了产妇住所PM2.5和NO2的精确估计。我们估计了268，601名新生儿在妊娠早期和中期暴露于PM2.5和NO2与妊娠高血压、轻度先兆子痫和重度先兆子痫风险之间的关系。在未经调整的分析中，我们发现了污染物和妊娠期高血压之间正相关的证据。然而，在调整了个体协变量、社会经济剥夺和分娩医院后，我们没有发现妊娠早期或中期PM2.5或NO2与任何结局之间存在关联的证据。我们的数据没有提供明确的证据表明环境空气污染对妊娠期高血压疾病的影响。考虑到现有暴露和健康结局指标的质量以及医院调整的不确定影响，需要谨慎解释结果。相对于以前的研究，这些研究倾向于确定与PM2.5和NO2的正相关性，我们的大研究规模，精确的空气污染暴露估计，基于医院的疾病确定，以及社会经济剥夺的混淆风险很小，并没有提供相关性的证据。
Previous studies suggested a possible association between fine particulate matter air pollution (PM2.5) and nitrogen dioxide (NO2) and the development of hypertensive disorders of pregnancy, but effect sizes have been small and methodologic weaknesses preclude firm conclusions. We linked birth certificates in New York City in 2008-2010 to hospital discharge diagnoses and estimated air pollution exposure based on maternal address. The New York City Community Air Survey provided refined estimates of PM2.5 and NO2 at the maternal residence. We estimated the association between exposures to PM2.5 and NO2 in the first and second trimester and risk of gestational hypertension, mild preeclampsia, and severe preeclampsia among 268,601 births. In unadjusted analyses, we found evidence of a positive association between both pollutants and gestational hypertension. However, after adjustment for individual covariates, socioeconomic deprivation, and delivery hospital, we did not find evidence of an association between PM2.5 or NO2 in the first or second trimester and any of the outcomes. Our data did not provide clear evidence of an effect of ambient air pollution on hypertensive disorders of pregnancy. Results need to be interpreted with caution considering the quality of the available exposure and health outcome measures and the uncertain impact of adjusting for hospital. Relative to previous studies, which have tended to identify positive associations with PM2.5 and NO2, our large study size, refined air pollution exposure estimates, hospital-based disease ascertainment, and little risk of confounding by socioeconomic deprivation, does not provide evidence for an association.