Ambient Air Pollution, Preeclampsia, and Preterm Delivery

描述（由申请人提供）：先兆子痫和早产是孕产妇和婴儿发病率和死亡率的重要原因。最近的研究表明，空气污染物暴露水平升高可能导致早产，即使是在美国许多城市典型的空气污染水平下。没有先前的研究直接检查了空气污染物暴露与先兆子痫的关系;尽管许多证据表明这种关系在生物学上是合理的。本研究基于参与大型队列研究的女性源人群。参与者在怀孕早期登记，并随访至分娩。我们将设计使用当地交通，天气和人口特征的模型来预测细颗粒物（PM2.5）和一氧化碳（CO）的每月环境浓度。这些模型将用于估计研究参与者在怀孕前和怀孕期间的PM2.5和CO暴露。我们将使用多变量逻辑回归程序来检验这些空气污染物暴露是否与随后的先兆子痫和早产风险相关。此外，我们将在孕早期采集的孕产妇血液样本中检测孕产妇脂质过氧化（硫代巴比妥酸反应物质）和炎症（高敏C反应蛋白）的生物标志物。我们将使用多变量回归来研究脂质过氧化和炎症作为空气污染物/疾病关系的生物学机制。我们还将检查早期妊娠母体血液样本中测量的碳氧血红蛋白作为CO暴露的标志物。我们将测试碳氧血红蛋白和妊娠结局之间的关系。研究结果有助于了解先兆子痫和早产的原因和机制。这些知识可能对制定这两种常见不良结局的预防干预措施具有重要意义。研究结果也可能有助于影响空气质量标准和政策的健康相关科学。

DESCRIPTION (provided by applicant): Preeclampsia and preterm delivery are important causes of maternal and infant morbidity and mortality. Recent studies suggest that elevated air pollutant exposures may lead to preterm delivery, even at air pollutant levels typical of those in many US cities. No prior studies have directly examined air pollutant exposure in relation to preeclampsia; although much evidence suggests that the relation is biologically plausible. This study is based on a source population of women participating in a large cohort study. Participants enroll during early pregnancy and are followed until delivery. We will design models that use local traffic, weather, and population characteristics to predict monthly ambient concentrations of fine particulate matter (PM2.5) and carbon monoxide (CO). These models will be used to estimate study participants' PM2.5 and CO exposures before and during pregnancy. We will test whether these air pollutant exposures are associated with subsequent risk of preeclampsia and preterm delivery using multivariable logistic regression procedures. Additionally, we will test biological markers of maternal lipid peroxidation (thiobarbituric acid reactive substances) and inflammation (high sensitivity C-reactive protein) in maternal blood samples drawn during early pregnancy. We will use multivariable regression to examine lipid peroxidation and inflammation as biological mechanisms in air pollutant/disease relationships. We will also examine carboxyhemoglobin measured in early-pregnancy maternal blood samples as a marker of CO exposure. We will test the associations between carboxyhemoglobin and the pregnancy outcomes. Study results could contribute to knowledge regarding the causes and mechanisms involved in preeclampsia and preterm delivery. Such knowledge may have significance in developing preventative interventions for these two common adverse outcomes. The results could also contribute to the body of heath-related science that influences air quality standards and policies.