妊娠期大气PM2.5暴露及体质量增加与妊娠期糖尿病发病的关系研究

Study on the relationship between PM2.5 exposure and body mass increase during pregnancy and the incidence of gestational diabetes mellitus

目的:探讨妊娠期大气PM2.5暴露和体质量增加对妊娠期糖尿病的影响。方法:选取2015-2018年进行产检的孕妇917例,问卷收集孕产妇的一般人口学信息、母亲孕产史,并进行随访调查;收集同期广州市PM2.5常规监测资料,获取PM2.5日平均浓度,根据孕妇家庭住址,利用反距离加权插值法获得每个孕妇个体污染物暴露水平,分析计算出孕早期和孕中期PM2.5暴露浓度。结果:随访后按妊娠期糖尿病诊断标准分为正常组739例和妊娠期糖尿病组178例。多因素Logistic回归分析显示,在孕早期和孕中期,体质量增加最高的一组比最低组妊娠期糖尿病发病风险升高,且孕期PM2.5暴露与孕期体质量增加存在交互作用,差异有统计学意义(P<0.05)。结论:孕期增重过快和大气PM2.5暴露均增加妊娠期糖尿病的风险,两者具有协同作用。

Objective:To explore the effects of exposure of atmospheric PM2.5 and weight gain during pregnancy on gestational diabetes mellitus.Methods:From 2015 to 2018,917 pregnant women who underwent obstetric examination were selected,the general demographic information,maternal history and follow-up investigation were collected by questionnaire.Collected the data of PM2.5 routine monitoring in Guangzhou during the same period and obtained the average daily concentration of PM2.5,the exposure levels of individual pollutants in each pregnant woman were obtained by inverse distance weighted interpolation method based on the home addresses of the pregnant woman and the exposure concentrations of PM2.5 of early and middle pregnancy were calculated.Results:After follow-up,the patients were divided into normal group with 739 cases and gestational diabetes group with 178 cases according to the diagnostic criteria of gestational diabetes mellitus.Multivariate logistic regression analysis showed that the group with the highest weight gain had a higher risk of gestational diabetes in the early and middle pregnancy than the lowest group,and there was an interaction between PM2.5 exposure during pregnancy and weight gain during pregnancy,the difference was statistically significant(P<0.05).Conclusion:Excessive weight gain during pregnancy and exposure of atmospheric PM2.5 both increase the risk of gestational diabetes and they both have a synergistic effect.