太原市大气污染物浓度对孕期睡眠质量的影响

The impact of atmospheric pollutant concentration on sleep quality during pregnancy in Taiyuan city

目的 分析太原市大气污染物浓度对孕妇孕期发生睡眠障碍的影响。方法 采用方便抽样方法,于2018年8月—2020年1月在太原市某医院门诊进行产检的孕妇548人,运用匹兹堡睡眠质量量表评估孕期睡眠情况,并记录同期太原市大气污染物暴露情况。将污染物浓度暴露时点分为5个:纳入研究当天、纳入研究前1周(滞后7 d)、前2周(滞后14 d)、前3周(滞后21 d)和前4周(滞后28 d)。采用两组间的单因素分析(Mann-Whitney U检验和χ^(2)检验)和二元logistic回归分析大气污染物对孕期睡眠质量的影响。结果太原市孕妇的睡眠障碍检出率51.82%。睡眠障碍组孕妇在各时点大气污染物暴露浓度普遍高于非睡眠障碍组孕妇。PM2.5与睡眠质量(rs=0.091,P<0.05)和睡眠障碍(rs=0.126,P<0.01)成正相关。二元logistic回归分析结果显示,滞后28 d时的PM2.5暴露水平是孕妇孕期发生睡眠障碍的危险因素(OR=1.03,95%CI:1.01~1.05)。结论 大气污染物对孕妇睡眠质量的影响可能存在滞后效应,其中PM2.5浓度升高会导致孕期睡眠障碍的发生风险增加,应加强孕期防护,减少大气污染对孕期健康的影响。

Objective To describe the impact of air pollutant concentration on sleep disorders during pregnancy in Taiyuan city,Shanxi province.Methods A total of 548 pregnant women were enrolled using a convenient sam‐pling method in a outpatient department of a hospital from August 2018 to January 2020.The sleep quality during pregnancy was evaluated using Pittsburgh Sleep Quality Scale,and the levels of air pollutants(SO2,NO2,CO,O3,PM2.5,PM10)in Taiyuan during the same period were recorded.The observation time points of exposure to air pol‐lutants included study inclusion day,one week before study inclusion(lag 7 d),two weeks before(lag 14 d),three weeks before(lag 21 d)and 4 weeks before(lag 28 d)study enrollment.Univariate analysis(Mann-Whitney U test andχ^(2) test)and binary logistic regression between the two groups were used to analyze the effects of air pollutants on sleep quality during pregnancy.Results The overall prevalence of sleep disorder in pregnant women in Taiyuan was 51.82%.The concentration of air pollutants of pregnant women with sleep disorder exposed to was generally higher than those with non-sleep disorder.PM2.5 was significantly positively correlated with sleep disturbance and sleep quality(rs=0.091,P<0.05;rs=0.126,P<0.01).Binary logistic regression analysis showed that PM2.5 ex‐posure levels with a lag of 28 d(OR=1.03,95%CI:1.01-1.05)was a risk factor for sleep disorders in pregnant women.Conclusions There is a potential lag effect of air pollutants on sleep quality in pregnant women.The risk of sleep disorders during pregnancy increases with a higher level of PM2.5 exposure.Thus,the periconcep‐tional period protection should be strengthened to reduce the impact of air pollution on pregnancy health.