渭河上游河谷型城市室外大气污染物与新生儿低出生体质量的关系研究

Relationship between outdoor air pollutants and low birth weight in urban areas of valley type cities in the upper reaches of Weihe River

目的探索室外大气污染物与低出生体质量的关系。方法回顾性分析2018年1月至2019年12月宝鸡市中心医院和宝鸡市人民医院产科收治的低出生体质量儿261例,健康足月儿5872例的临床资料。分析低出生体质量儿和足月产儿在胎龄、母亲年龄、剖次、本次分娩情况、妊娠并发症、妊娠期高血压综合征、孕期服药史等混杂因素的差异。大气污染物数据来源于该市八个空气质量监测站点,计算孕妇在孕早期(T1)、孕中期(T2)的PM_(10)、PM_(2.5)、SO_(2)、NO_(2)、CO、O_(3)的个体暴露水平。利用logistic回归模型分析大气污染物暴露与新生儿低出生体质量的关系。结果纳入6133个单胎活产婴儿中,共发现261名低出生体质量新生儿(占比4.3%)。对比低出生体质量儿和正常足月产儿发现,其孕妇在孕早期(T1)的CO暴露剂量差异有统计学意义(P<0.05)。logistic分析结果显示:胎龄、剖次为低出生体质量的危险因素(OR=43.448、2.131),尚未发现大气污染物与新生儿低出生体质量存在统计学意义。结论本研究虽然发现CO的暴露剂量可能会影响出生体质量,但并未发现不同孕期大气污染物是新生儿低出生体质量的独立危险因素。

Objective To explore the relationship between outdoor air pollutants and low birth weight.Methods From January 2018 to December 2019,the clinical date of 261 cases of low birth weight infants and 5872 cases of healthy term infants were analyzed retrospec-tively.To analyze the differences between low birth weight infants and full-term infants were analyzed in terms of gestational age,maternal age,cesarean section,current delivery situation,pregnancy complications,pregnancy hypertension syndrome,pregnancy medication history and other confounding factors.The data of air pollutants were from eight air quality monitoring stations in the city,and the individual exposure levels of PM_(10),PM_(2.5),SO_(2),NO_(2),CO and O_(3) of pregnant women during the early pregnancy(T1)and middle pregnancy(T2)were calculated.Lo-gistic regression model was used to analyze the relationship between air pollution exposure and low birth weight of newborns.Results A total of 261 low birth weight newborns(4.3%)were found among 6133 single birth live births.Comparing low birth weight and normal full-term in-fants,it was found that the CO exposure dose of pregnant women during the early pregnancy(T1)was significantly different(P<0.05).The re-sults of logistic analysis showed that gestational age,cesarean section were all risk factors for low birth weight(OR=43.448、2.131),but no statis-tical significance was found between air pollutants and low birth weight of newborn.Conclusion Although this study finds that the exposure dose of CO might affect the birth weight,it does not find that the air pollutants in different pregnancy periods were independent risk factors for low birth weight of newborns.