某市空气污染对早产影响的病例对照研究

Association between Air pollution and Preterm Birth: a Case Control Study

目的探讨某市空气污染物SO2、NO2和可吸入颗粒物（PM10）对早产的影响。方法选取某市某助产机构2009年6月30日-9月30日分娩的产妇及围产儿为研究对象，对其进行问卷调查和病历摘录，以妊娠满28周不足37周的86例新生儿为病例组，妊娠满37周至42周的771例新生儿为对照组。空气污染数据来自该市环境保护监测站，包括2008年6月1日至2009年9月30日3种空气污染物（PM10、SO2、NO2）逐日平均浓度。应用Logistic回归模型控制早产的混杂因素后，分析空气污染物对早产的影响。结果在单污染模型中，孕早期、孕中期、孕晚期的NO2和PM10暴露对早产有影响，其暴露浓度每上升一个四分位数，发生早产的OR值分别为1．135（95％CI：1．100～1．172）、2．044（95％CI：1．696～2．462）、1．157（95％CI：1．008～1．329）和1．149（95％CI：1．109—1．191）、1．241（95％CI：1．176～1．310）、1．053（95％CI：1．002—1．106），SO2仅在孕早期暴露会增加早产的风险，发生早产的OR值为1．646（95％CI：1．437～1．887）；在双污染物模型中，孕前3个月SO2、NO2和PM10的污染物暴露对早产有影响；当3种污染物同时包括在模型中时，孕前3个月的SO2、NO2暴露会增加早产的风险，发生早产的OR值为1．708（95％CI：1．312～2．222）和5．853（95％CI：1．507—22．723），PM10对早产的影响无统计学意义。结论该市大气NO2、PM10、SO2污染可能与早产有关。

Objective To analyze the influence of sulfur dioxide（SO2）,nitrogen dioxide（NO2）and inhalable particulate matter--.〈 10 μm in aerodynamic size （PM10） in outdoor air pollution on preterm birth. Methods The parturients were selected in a midwifery institution in a city from June 30 to September 30, 2009. The pregnant women with full 28 to 37 gestational weeks were selected as the case group and those pregnant women with full 37 to 42 gestational weeks as the control group. The air pollution data from a city environmental protection monitoring stations, including three kinds of air pollutants （NO2,PM10,SO2） daily average concentration in 2008--2009 in this city. Logistic regression model was used for the analysis of influence of air pollutants on preterm birth. Results In a single pollution model, early pregnancy, second trimester, third trimester of NO2 and PM10 exposure on preterm birth had a significant effect , increased its exposure in a quartile of each, the relative risk of premature delivery occurred were 1.135 （95%CI： 1.100-1.172）, 2.044 （95%CI： 1.696-2.462）, 1.157 （95%CI： 1.008-1.329）and 1.149 （95%CI： 1.109-1.191 ）, 1.241 （95%CI： 1.176-1.310）, 1.053 （95%Ch 1.002-1.106）,SO2 exposure only in early pregnancy increased the risk of preterm birth, preterm labor＇s relative risk 1.646 （95%CI： 1.437-1.887）;In double pollutants model, three-month prepregnancy exposure to SO2, NO2 and PM10 had a significant effect on premature; when the three kinds of pollutants were selected simultanously in the model, three-month pre-pregnaney exposure to SO2, NO2 increased the risk of preterm birth, preterm labor＇s relative risk[1.708（95%Cl：l.312-2.222） and 5.853（95%（;1：1.507-22.723）]. Conclusion Air pollutants ,such as NO2, PM10 and SO2 ,may have a association with preterm birth in this city.