妊娠期大气污染暴露对早产影响的流行病学研究

Effect of prenatal exposure to air pollution on preterm birth: an epidemiological analysis

目的研究妊娠期大气污染暴露对早产的影响。方法利用上海市某区2013年出生监测系统收集孕产妇基本情况和新生儿出生信息,3种大气污染物（SO_2、NO_2、PM_（10））暴露数据来自该区环境监测中心提供的逐日平均浓度。在控制早产的各类影响因素后,应用logistic回归模型评价大气污染物对早产的影响。结果该研究共纳入孕满28周的单胎活产新生儿38 083例,其中早产1 782例。新生儿性别、出生胎次、出生产次、有无畸形、分娩季节、母亲年龄、母亲文化程度和母亲户籍等多个因素与早产有关。孕晚期、孕期SO_2和PM_（10）暴露对早产有影响,OR值分别为1.07（95%CI：1.06～1.08）、1.16（95%CI：1.11～1.21）、1.03（95%CI：1.02～1.03）和1.04（95%CI：1.03～1.06）,NO_2仅在孕晚期暴露时增加早产风险,OR值为1.04（95%CI：1.03～1.05）。结论该区大气污染物SO_2、NO_2、PM_（10）暴露与早产有关。

[Objective]To evaluate the impacts of prenatal exposure to air pollution on preterm birth.[Methods]The basic situation of pregnant women and birth information of neonatal were collected from the Birth Monitoring Network in a district of Shanghai in2013,and daily air pollution data for SO_2,NO_2 and PM_（10）were obtained from local Environmental Monitoring Center. Logistic regression analysis was used to examine the associations between air pollution and preterm birth after controlling for the influencing factors of preterm birth. [Results]38 083 singleton live births were enrolled in this study,including 1 782 cases of preterm birth. The sex of neonatal,birth order,birth time,deformity,delivery season,age of mother,education level of mother,and registered permanent residence of mother were the influencing factors of preterm birth. The exposure to SO_2 and PM_（10）in late pregnancy and pregnancy period were related to preterm birth,and the OR value was 1.07（95% CI：1.06-1.08）,1.16（95% CI：1.11-1.21）,1.03（95% CI：1.02-1.03） and 1.04（95% CI：1.03-1.06）,respectively. The exposure to NO2 in only late pregnancy increased the risk of preterm birth and the OR value was 1.04（95% CI：1.03-1.05）. [Conclusion]The prenatal exposure to air pollution（SO_2,NO_2 and PM_（10））is associated with the risk of preterm birth.