妊娠期PM_(10)暴露与足月低出生体重关联分析

Association of PM_(10) exposure during pregnancy with full-term low birth weight

目的分析妊娠期可吸入颗粒物(inhalable particles,PM_(10))暴露与足月低出生体重的关联性。方法收集2016——2017年在河北省22所监测医院入院分娩的110171名孕产妇住院资料,利用其所在城市的每日空气质量数据测算不同妊娠阶段及不同城市PM_(10)的暴露情况,采用Logistic回归分析不同妊娠阶段及整个妊娠期不同特征分层PM_(10)暴露与足月低出生体重的关联,利用分布滞后非线性模型对其敏感暴露窗口进行验证。结果足月低出生体重组妊娠期各阶段PM_(10)暴露水平均高于足月非低出生体重组;妊娠期暴露于PM_(10)会增加足月低出生体重的发生风险,整个妊娠期、妊娠早期、妊娠中期和妊娠晚期PM_(10)每增加10μg/m^(3),足月低出生体重的发生风险分别增加至原来的1.039、1.012、1.012和1.016倍(P<0.05)。分层分析显示,母亲年龄<35岁、单胎妊娠,整个妊娠期PM_(10)浓度每增加10μg/m^(3),足月低出生体重的发生风险均增加至原来的1.039倍。此外,足月低出生体重发生风险增加与第20-25孕周PM_(10)暴露有关。结论妊娠期PM_(10)暴露为足月低出生体重的危险因素,尤其是孕20-25周,孕妇年龄<35岁、单胎妊娠是PM_(10)暴露对足月低出生体重风险的潜在影响因素,需注意做好妊娠期防护。

Objective To investigate the association between exposure to inhalable particles(PM_(10)) during pregnancy and fullterm low birth weight.Methods The hospitalization data of 110171 pregnant and parturient women,who had their deliveries in 22 hospitals monitored in Hebei Province,China in 2016-2017,were collected.The exposure of pregnant and parturient women to PM_(10) at different stages of pregnancy in different cities was estimated based on the daily air quality monitoring data of their cities.The association of PM_(10) exposure at different stages of pregnancy and during the whole pregnancy with full-term low birth weight in the women stratified by different features was analyzed by logistic regression,and the sensitive exposure window was validated by the distributed lag nonlinear model.Results The exposure level of PM_(10) at all stages of pregnancy in the full-term low birth weight group was higher than that in the full-term non-low birth weight group.PM_(10) exposure during pregnancy increased the risk of full-term low birth weight.The risk of full-term low birth weight increased to 1.039,1.012,1.012,and 1.016 times the original value for every 10μg/m^(3)increase in PM_(10) exposure during the whole pregnancy and in the first,second,and third trimesters of pregnancy,respectively(P<0.05).The stratified analysis showed that the risk of full-term low birth weight increased to 1.039 times the original value for every 10μg/m^(3) increase in PM_(10) mass concentration during the whole pregnancy in women aged<35 years with single pregnancy.In addition,an increased risk of full-term low birth weight was associated with PM_(10) exposure at gestational 20th to 25th weeks.Conclusion PM_(10) exposure during pregnancy,especially at gestational 20th to 25th weeks,is a risk factor for full-term low birth weight.An age of<35 years and single pregnancy in pregnant women are potential influencing factors for the association of PM_(10) exposure with the risk of full-term low birth weight,thus protective measures against exposure should be adopted among pregnant women.