Ambient temperature and air quality in relation to small for gestational age and term low birthweight.
Ambient temperature and air quality in relation to small for gestational age and term low birthweight.
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DOI：
10.1016/j.envres.2017.02.021
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发表时间：
2017-05
影响因子：
8.3
通讯作者：
Mendola P
中科院分区：
文献类型：
--
作者：
Ha S;Zhu Y;Liu D;Sherman S;Mendola P
暴露于极端环境温度和空气污染与不良出生结局有关，但与小于胎龄 (SGA) 和足月低出生体重 (tLBW) 的关系尚不清楚。我们的目的是调查特定地点极端温度的暴露情况以及与 SGA 和 tLBW 相关的选定标准空气污染物。我们将美国 12 个地点的 220,572 名单胎出生（2002 年至 2008 年）的医疗记录与天气研究和预报模型估计的当地温度以及修改后的社区多尺度空气质量模型估计的空气污染联系起来。暴露于热（> 95%）和冷（< 5%）是使用三个月前、每个三个月和整个怀孕期间每日温度的特定地点分布来定义的。还计算了这些怀孕窗口的五种标准空气污染物和六种细颗粒物成分的平均浓度。使用广义估计方程的泊松回归计算了与空气污染物四分位数范围增量相关的 SGA（体重 < 第 10 个百分位，以胎龄和性别为条件）和 tLBW（≥ 37 周且 <2,500 克）的相对风险 (RR) 和 95% 置信区间，以及与温和（第 5-95 个百分位）温度相比的冷或热。根据母亲的人口统计数据、生活方式、临床因素、季节和地点对模型进行了调整。与温和温度相比，第 2 个月 [RR：1.21 (1.05–1.38)]、第 3 个月 [RR：1.18 (1.03–1.36)] 和整个妊娠期 [RR：2.57 (2.27–2.91)] 期间的寒冷暴露；第 3 个月的热暴露 [RR：1.31 (1.15–1.50)] 和整个妊娠期 [RR：2.49 (2.20–2.83)] 会增加 tLBW 风险。温度和 SGA 之间没有观察到一致的关联。空气污染物分析通常无效，但先入为主的元素碳与 SGA 增加 4% 相关，而灰尘颗粒则使 tLBW 增加 10%。孕中期和整个孕期颗粒物≤10微米也出现与tLBW相关。结论：我们的研究结果表明，产前暴露于相对于平常环境的极端环境温度可能会增加 tLBW 风险。考虑到与气候变化有关的担忧，这些发现值得进一步研究。
Exposures to extreme ambient temperature and air pollution are linked to adverse birth outcomes, but the associations with small for gestational age (SGA) and term low birthweight (tLBW) are unclear. We aimed to investigate exposures to site-specific temperature extremes and selected criteria air pollutants in relation to SGA and tLBW. We linked medical records of 220,572 singleton births (2002–2008) from 12 US sites to local temperature estimated by the Weather Research and Forecasting model, and air pollution estimated by modified Community Multiscale Air Quality models. Exposures to hot (>95th percentile) and cold (<5th percentile) were defined using site-specific distributions of daily temperature over three-month preconception, each trimester, and whole-pregnancy. Average concentrations of five criteria air pollutants and six fine particulate matter constituents were also calculated for these pregnancy windows. Poisson regression with generalized estimating equations calculated the relative risks (RR) and 95% confidence intervals for SGA (weight <10th percentile conditional on gestational age and sex) and tLBW (≥37 weeks and <2,500 grams) associated with an interquartile range increment of air pollutants, and cold or hot compared to mild (5–95th percentile) temperature. Models were adjusted for maternal demographics, lifestyle, and clinical factors, season, and site. Compared to mild temperature, cold exposure during trimester 2 [RR: 1.21 (1.05–1.38)], trimester 3 [RR: 1.18 (1.03–1.36)], and whole-pregnancy [RR: 2.57 (2.27–2.91)]; and hot exposure during trimester 3 [RR: 1.31 (1.15–1.50)] and whole-pregnancy [RR: 2.49 (2.20–2.83)] increased tLBW risk. No consistent association was observed between temperature and SGA. Air pollutant analyses were generally null but preconception elemental carbon was associated with a 4% increase in SGA while dust particles increased tLBW by 10%. Particulate matter ≤10 microns in the second trimester and whole pregnancy also appeared related to tLBW. Conclusions: Our findings suggest prenatal exposures to extreme ambient temperature relative to usual environment may increase tLBW risk. Given concerns related to climate change, these findings merit further investigation.