邯郸市妇女空气污染暴露对妊娠期高血压的影响

Maternal exposure to ambient air pollution and gestational hypertension in Handan

选择河北省邯郸市某医院孕妇数据,探讨了6项空气污染物暴露对孕妇患妊娠期高血压(GH)的影响和不同人群的效应差异,采用传统Logistic回归模型评估了各项污染物的效应,采用主成分改进的Logistic回归模型评估了各项污染物在额外调整其它污染物后的效应.结果显示,单污染物模型中,妊娠期前26周每20μg/m^(3)增量的O_(3)暴露与患病风险呈显著正相关关系(OR=1.211,95%CI:1.094~1.340),且在妊娠前期的效应大于在妊娠中期的效应.多污染物模型中,孕前3个月每20μg/m^(3)增量的PM_(2.50和PM_(10)暴露显著增加了患病的风险,OR值分别为1.021(95%CI:1.004~1.038)和1.016(95%CI:1.002~1.031);妊娠期前26周每20μg/m^(3)增量的O_(3)暴露也对患病风险有显著效应(OR=1.026,95%CI:1.002~1.050).亚组分析结果显示,25~30岁或初次妊娠的孕妇孕前3个月对PM_(2.5)、PM_(10)、NO_(2)和CO的暴露较为敏感,>35岁或学历为大学以下的孕妇妊娠期前26周受O_(3)暴露的影响更易患病.总的来说,邯郸市空气污染对孕妇患GH存在显著的影响,孕妇应在孕前和妊娠期间做好防护,降低空气污染暴露造成的不利影响.

The traditional logistic regression model was used to evaluate the effects of exposure to various pollutants on GH,and the logistic regression model based on principal component analysis was used to evaluate the effects on GH by additionally adjusting parameters of other pollutants.Results of single-pollutant model showed that each 20μg/m^(3) increment of O_(3) was significantly positively correlated with the increased risk of GH(OR=1.211,95%CI:1.094~1.340)during the first 26 weeks of gestation,and the effect in the first trimester was greater than that in the second trimester.In multi-pollutant model,each 20μg/m^(3) increment of PM_(2.5) and PM_(10) exposure significantly increased the GH risk of pregnant women in the three months before pregnancy,with OR values of 1.021(95%CI:1.004~1.038)for PM_(2.5) and 1.016(95%CI:1.002~1.031)for PM_(10).Consistent with the results of single-pollutant model,each 20μg/m^(3) increment of O_(3) exposure also had a significant effect on the risk of GH(OR=1.026,95%CI:1.002~1.050)during the first 26 weeks of gestation in multi-pollutant model.The results of subgroup analysis showed that pregnant women aged 25~30 years or those in the first pregnancy were susceptible to PM_(2.5),PM_(10),NO_(2) and CO exposure before pregnancy,while pregnant women over 35 years old or without college degrees were more likely to develop GH due to O_(3) exposure during pregnancy.In summary,air pollution in Handan has significant impacts on pregnant women inducing suffering from GH.To mitigate the negative impacts of exposure to air pollution,more attention should be paid to the enhancement of air pollution protection awareness for pregnant women before and during pregnancy.