某市城区室外大气污染物与早产的病例对照研究

Association of air pollution exposure with premature birth in a urban area:a case-control study

目的研究某市城区孕妇孕期空气污染物暴露水平与早产之间的关系,为降低早产发生的风险提供依据。方法收集2018年1月1日—2019年12月31日某市城区两家三甲医院分娩的早产儿与足月产孕产妇信息,采用1∶1的病例对照研究,分析影响妊娠结局的因素,确定暴露剂量反应关系模型。结果足月产组与早产组孕妇的整个孕期SO_(2)、NO_(2)、PM_(2.5)、PM_(10)、O_(3)和孕中期CO暴露水平差异有统计学意义(P<0.05)。Logistic回归分析显示,年龄(OR=0.92,95%CI:0.89~0.96)、孕次(OR=0.86,95%CI:0.75~0.98)、剖次(OR=0.83,95%CI:0.66~1.05)、Apgar评分(OR=0.20,95%CI:0.04~0.89)、妊娠期并发症(OR=0.26,95%CI:0.19~0.36)、妊娠期高血压综合征(OR=5.35,95%CI:3.10~9.21)、胎数(OR=16.68,95%CI:4.80~57.92)、整个孕期PM_(2.5)(OR=0.88,95%CI:0.79~0.99)和PM_(10)(OR=1.06,95%CI:1.01~1.10)对早产发生的妊娠结局有影响(P<0.05)。结论整个孕期PM_(10)暴露会增加早产发生的风险。

Objective To explore the association between outdoor air pollution exposure during pregnancy and premature birth in a urban area,and provide evidence for reducing the risk of preterm delivery.Methods A retrospective case-control study was conducted among women who delivered babies from January 1,2018 to December 31,2019 in two grade A hospitals with either preterm birth(case)or full-term birth(control).Factors affecting pregnancy outcomes were analyzed and exposure dose-response model was determined.Results The differences in the exposure levels to SO_(2),NO_(2),PM_(2.5),PM_(10),O_(3) during the entire pregnancy and to CO during the second trimester were statistically significant between the two groups(P<0.05).Logistic regression analysis showed that age(OR=0.92,95%CI:0.89-0.96),gravidity(OR=0.86,95%CI:0.75-0.98),number of caesarean section(OR=0.83,95%CI:0.66-1.05),Apgar score(OR=0.20,95%CI:0.04-0.89),pregnancy complications(OR=0.26,95%CI:0.19-0.36),gestational hypertension(OR=5.35,95%CI:3.10-9.21),fetus number(OR=16.68,95%CI:4.80-57.92),PM_(2.5)level(OR=0.88,95%CI:0.79-0.99)and PM_(10)level(OR=1.06,95%CI:1.01-1.10)during the entire pregnancy were major factors related to the premature delivery in Yan′an urban area(P<0.05).Conclusions PM_(10)exposure during the entire pregnancy can significantly increase the risk of preterm delivery.