Migrant population is more vulnerable to the effect of air pollution on preterm birth: Results from a birth cohort study in seven Chinese cities
Migrant population is more vulnerable to the effect of air pollution on preterm birth: Results from a birth cohort study in seven Chinese cities
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流动人口更容易受到空气污染对早产的影响：中国七个城市的出生队列研究结果
DOI：
10.1016/j.ijheh.2019.07.004
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发表时间：
2019-08-01
影响因子：
6
通讯作者：
Zhao, Qingguo
中科院分区：
文献类型：
--
作者：
Liang, Zhijiang;Yang, Yin;Zhao, Qingguo
背景：研究报告称，怀孕期间暴露于空气污染与早产（PTB）有关。然而，目前尚不清楚当地居民和流动人口之间的这种关联是否存在差异。目的：本研究旨在区分当地居民和流动人口之间孕产妇空气污染暴露与PTB之间的关联。方法：我们在2015年至2017年期间在中国珠江三角洲（珠三角）地区的七个城市建立了回顾性出生队列。母亲在首次因怀孕住院时被纳入队列，并使用出生登记确定终点事件。根据不同妊娠期附近空气监测站的每日空气污染浓度估计空气污染暴露。考克斯比例风险模型被用来估计每种空气污染物和PTB之间的关联，为不同pregnationperiods.Results：我们的队列共包括628,439母亲和活产对。其中，308 201名妇女为当地居民，320 238名为流动人口。我们观察到空气污染物对移民的影响比当地居民更强。流动人口与当地居民孕期暴露的危险比为1.56（95% CI：1.50，1.63）和0.98（95% CI：0.93，1.02）PM2.5每增加10 μ g/m3，1.32（95% CI：1.27，1.39）和1.18（95%CI：1.12，1.23），SO2每增加10 μ g/m3分别为1.48（95%CI：1.40，1.57）和0.99（95%CI：0.93，1.05）。同样，在移徙者中观察到不同孕期接触的影响更大。结论：PM2.5、O-3和SO2暴露可能是早产的重要危险因素，尤其是在流动人口中。应考虑对流动孕妇采取更具体的保护和教育措施。
Background: Studies have reported that exposure to air pollution during pregnancy was associated with preterm birth (PTB). However, it remains unknown whether this association differs between local residents and migrants.Objective: This study aimed to differentiate the associations between maternal air pollution exposure and PTB between local residents and migrants.Methods: We established a retrospective birth cohort in seven Chinese cities in Pearl River Delta (PRD) region during 2015-2017. The mothers were included in the cohort at their first time of hospital visit for pregnancy, and the endpoint events were identified using the birth registry. The air pollution exposure was estimated based on the daily air pollution concentrations in the nearby air monitoring stations during different pregnancy periods. Cox proportional hazards models were utilized to estimate the associations between each air pollutant and PTB for different pregnancy periods.Results: Our cohort included a total of 628,439 mother-and-live-birth pairs. Among them, 308,201 women were local residents, and 320,238 were migrants. We observed stronger effects of air pollutants among the migrants than the local residents. For the exposure during the entire pregnancy, the hazard ratio (HR) among the migrants and local residents were 1.56 (95% CI: 1.50, 1.63) and 0.98 (95% CI: 0.93, 1.02) for each 10 mu g/m(3) increase in PM2.5, 1.32 (95% CI: 1.27, 1.39) and 1.18 (95% CI: 1.12, 1.23) for each 10 ppb increase in O-3, and 1.48 (95% CI: 1.40, 1.57) and 0.99 (95% CI: 0.93, 1.05) for each 10 mu g/m(3) increase in SO2, respectively. Similarly higher effects were observed among the migrants for the exposures in different trimesters of pregnancy. However, the effects of NO2 were comparable between the two groups.Conclusion: Our study suggests that maternal PM2.5, O-3 and SO2 exposures might be important risk factors of preterm birth, particularly among the migrants. More specific protective and education measures should be considered for the migrant pregnant women.