Ambient carbon monoxide and fine particulate matter in relation to preeclampsia and preterm delivery in western Washington State.
Ambient carbon monoxide and fine particulate matter in relation to preeclampsia and preterm delivery in western Washington State.
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DOI：
10.1289/ehp.1002947
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发表时间：
2011-06
影响因子：
10.4
通讯作者：
Schiff MA
中科院分区：
文献类型：
--
作者：
Rudra CB;Williams MA;Sheppard L;Koenig JQ;Schiff MA
早产和先兆子痫是常见的不良妊娠结局，与环境空气污染物暴露不一致。我们旨在前瞻性地研究暴露在环境一氧化碳(CO)和细颗粒物[PM2.5空气动力学直径(≤2.5μm)]与先兆子痫和早产风险之间的关系。我们使用的数据来自华盛顿州西部的3509名妇女，她们在1996年至2006年间分娩。我们基于区域空气污染物监测数据，使用回归模型预测了环境中CO和PM2.5的暴露量。模型包含年、月、天气和土地利用特征的预测项。我们评估了几个暴露窗口，包括孕前、怀孕早期、前两个三个月、最后一个月和怀孕最后三个月。使用抽象的产妇病历数据来确定结果。协变量信息来自母亲访谈。在调整了母亲的特征和受孕季节后，预测的围孕期一氧化碳暴露与先兆子痫显著相关[调整后的优势比(OR)每0.1ppm=1.07；95%可信区间(CI)，1.02-1.13]。然而，对受孕年份的进一步调整基本上使这种联系无效(调整后的OR=0.98；95%CI，0.91-1.06)。PM2.5和先兆子痫之间的相关性并不显著，而且比估计的一氧化碳相关性更弱，而且这两种空气污染物与早产都没有很强的相关性。所有暴露窗口的模式都是相似的。由于CO浓度和子痫前期发病率在研究期间均有所下降，另一个子痫前期危险因素的长期变化可能解释了在此观察到的关联。在这种情况下，我们几乎没有看到其他与先兆子痫或早产有关的证据。
Preterm delivery and preeclampsia are common adverse pregnancy outcomes that have been inconsistently associated with ambient air pollutant exposures. We aimed to prospectively examine relations between exposures to ambient carbon monoxide (CO) and fine particulate matter [≤ 2.5 μm in aerodynamic diameter (PM2.5)] and risks of preeclampsia and preterm delivery. We used data from 3,509 western Washington women who delivered infants between 1996 and 2006. We predicted ambient CO and PM2.5 exposures using regression models based on regional air pollutant monitoring data. Models contained predictor terms for year, month, weather, and land use characteristics. We evaluated several exposure windows, including prepregnancy, early pregnancy, the first two trimesters, the last month, and the last 3 months of pregnancy. Outcomes were identified using abstracted maternal medical record data. Covariate information was obtained from maternal interviews. Predicted periconceptional CO exposure was significantly associated with preeclampsia after adjustment for maternal characteristics and season of conception [adjusted odds ratio (OR) per 0.1 ppm = 1.07; 95% confidence interval (CI), 1.02–1.13]. However, further adjustment for year of conception essentially nullified the association (adjusted OR = 0.98; 95% CI, 0.91–1.06). Associations between PM2.5 and preeclampsia were nonsignificant and weaker than associations estimated for CO, and neither air pollutant was strongly associated with preterm delivery. Patterns were similar across all exposure windows. Because both CO concentrations and preeclampsia incidence declined during the study period, secular changes in another preeclampsia risk factor may explain the association observed here. We saw little evidence of other associations with preeclampsia or preterm delivery in this setting.
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