围孕期空气污染暴露与子代先天性甲状腺功能减退的关系:基于中国30个省份的研究

The associations between periceonceptional exposure to air pollution and the congenital hypothyroidism for newborns: a study based on 30 provinces in China

目的探讨围孕期母体空气污染暴露水平对子代先天性甲状腺功能减退症(CH)发病风险的影响。方法回顾性收集中国2014年10月1日至2015年9月31日30个省份CH的发病率。遵循空气污染对妊娠期效应的滞后性和累积性原则,回顾性收集中国30个省份2014年1月1日至2015年9月31日PM2.5、PM10、NO2、SO2、CO和O3的平均暴露水平。构建二项Logistic回归模型,并纳入各省份人均国民生产总值、废水中铅、汞和砷的暴露量作为混杂因素,分析围孕期空气污染暴露对子代CH发病风险的影响。结果我国2015年CH的年发病率约为4.31/万人,其中浙江省(7.42/万人)和福建省(7.34/万人)的发病率最高,发病率最低的省份为新疆(1.88/万人)。围孕期母体PM2.5高暴露会显著增加CH的发病风险,围孕期PM2.5的暴露水平每上升1μg/m3,该地区CH高发的风险将会增加0.102倍(OR=1.102, 95%CI:1.001~1.213,P <0.05)。此外,围孕期NO2平均暴露水平的升高也会显著增加CH的发病风险(OR=1.211, 95%CI:1.033~1.419, P <0.05)。在双污染物模型中,围孕期母体PM2.5和NO2的高暴露仍会显著增加CH的发病风险,当对PM10的暴露水平进行调整后,PM2.5和NO2暴露对CH发病率的影响均最为显著(OR=1.585、1.580,均P <0.05)。但PM10、SO2、CO和O3对CH的发病风险没有显著的影响(OR=1.007、0.987、0.925、0.061,均P>0.05)。结论本研究通过大数据分析发现,围孕期母体PM2.5和NO2高暴露会显著增加子代CH的发病风险。围孕期空气污染暴露可能影响子代腺体功能的发育。

Objective To explore the effects of maternal exposure to air pollution during peri-ceonception on the risk of congenital hypothyroidism(CH) in offspring. Methods The incidence of CH in 30 provinces of China from October 1, 2014 to September 31, 2015 was retrospectively collected. Following the principle of the hysteresis and accumulation effects of air pollution on pregnancy, we also retrospectively collected the average exposure levels of PM2.5, PM10, NO2, SO2, CO and O3 in 30 provinces of China from January 1, 2014 to September 31, 2015. And then GDP per capita and the exposure levels of lead, mercury and arsenic in wastewater of each province were taken into the built binomial logistic regression models to analyze the effects of periceonceptional exposure to air pollution on the risk of CH in offspring. Results The annual incidence of CH in China in 2015 was about 4.31 per 10 000 screened newborns, among which Zhejiang province(7.42 per 10 000 screened newborns) and Fujian province(7.34 per 10 000 screened newborns) had the highest incidence of CH, and Xinjiang province(1.88 per 10 000 screened newborns) had the lowest incidence of CH. High exposure to PM2.5 during peri-ceonceptionsignificantly increased the risk of CH, for per 1 μg/m3 increase in PM2.5 exposure during peri-ceonception might increase the risk of higher incidence of CH by 0.102 times(adjusted OR = 1.102, 95%CI: 1.001 ~ 1.213, P<0.05). And per 1 μg/m3 increase in NO2 exposure also increased the risk of CH significantly(adjusted OR = 1.211, 95%CI: 1.033 ~1.419, P<0.05). In two-pollutant models, periceonceptional exposure of PM2.5 and NO2 still increased the risk of CH significantly, and after adjusting the exposure level of PM10, periceonceptional exposure to PM2.5 and NO2 exposure all had the most significant effects on the risk of CH(OR values were 1.585 and 1.580, respectively, all P<0.05. But PM10, SO2, CO and O3 exposure during peri-ceonception had no significant effects on the risk of CH(OR values were 1.007, 0.987, 0.925 and 0.061, respectively, all P>0.05). Conclusion Through big data analysis, our study have found that high exposure to PM2.5 and NO2 during peri-ceonception would significantly increase the risk of CH in the offspring. And periceonceptional exposure to air pollution might affect the development of gland function in offspring.