Ambient air pollution and preterm birth in the environment and pregnancy outcomes study at the University of California, Los Angeles
Ambient air pollution and preterm birth in the environment and pregnancy outcomes study at the University of California, Los Angeles
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DOI：
10.1093/aje/kwm181
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发表时间：
2007-11-01
影响因子：
5
通讯作者：
Ghosh, Jo Kay C.
中科院分区：
文献类型：
--
作者：
Ritz, Beate;Wilhelm, Michelle;Ghosh, Jo Kay C.
作者进行了一项嵌套在出生队列中的病例对照调查，并收集了详细的风险因素信息，以评估残留混杂和暴露错误分类可能影响空气污染效应估计的程度。2003年，在加州的洛杉矶县，从58,316名符合条件的新生儿中抽取了6,374名妇女，对其中的2,543名妇女进行了调查，作者用逻辑回归和两阶段模型估计了怀孕期间特定空气污染暴露对早产几率的影响。在妊娠早期，早产的几率随着一氧化碳暴露的增加而增加，并且在高水平暴露于直径小于或等于2.5 μ m的颗粒物（>21.4 μ g/m3）时也是如此，无论数据类型（队列/样本）或协变量调整（一氧化碳暴露>1.25 ppm增加了21-25%的几率）。在怀孕的最后6周内，暴露于0.91 ppm以上一氧化碳的妇女早产的几率增加。一氧化碳的粗品和出生证明协变量调整结果彼此不同。然而，在调查中评估的风险因素的进一步调整并没有改变短期污染物平均值的影响估计明显，除了时间活动模式，这加强了观察到的关联。这些结果证实了在评估与交通有关的污染物的影响时，减少暴露错误分类的重要性。
The authors conducted a case-control survey nested within a birth cohort and collected detailed risk factor information to assess the extent to which residual confounding and exposure misclassification may impact air pollution effect estimates. Using a survey of 2,543 of 6,374 women sampled from a cohort of 58,316 eligible births in 2003 in Los Angeles County, California, the authors estimated with logistic regression and two-phase models the effects of pregnancy period-specific air pollution exposure on the odds of preterm birth. For the first trimester, the odds of preterm birth consistently increased with increasing carbon monoxide exposures and also at high levels of exposure to particulate matter less than or equal to 2.5 mu m in diameter (>21.4 mu g/m(3)), regardless of type of data (cohort/sample) or covariate adjustment (carbon monoxide exposures of >1.25 ppm increased the odds by 21-25%). Women exposed to carbon monoxide above 0.91 ppm during the last 6 weeks of pregnancy experienced increased odds of preterm birth. Crude and birth certificate covariate-adjusted results for carbon monoxide differed from each other. However, further adjustment for risk factors assessed in the survey did not change effect estimates for short-term pollutant averages appreciably, except for time-activity patterns, which strengthened the observed associations. These results confirm the importance of reducing exposure misclassification when evaluating the effect of traffic-related pollutants that vary spatially.