黄河沿岸河南农村地区孕期大气污染物暴露与早产的关系  

Association between prenatal exposure to air pollution and risk of preterm birth in rural Henan along the Yellow River

作　　者：李沁洋 龚勇祥 柴健 周郭育 张军喜 孙盼盼 余方方 蒋丽芳 邓启红 巴月 LI Qinyang;GONG Yongxiang;CHAI Jian;ZHOU Guoyu;ZHANG Junxi;SUN Panpan;YU Fangfang;JIANG Lifang;DENG Qihong;BA Yue(Department of Environmental Health,College of Public Health,Zhengzhou University,Zhengzhou 450001;Henan Institute of Reproduction Health Science and Technology&National Health Commission Key Laboratory of Birth Defects Prevention,Zhengzhou 450002)

机构地区：[1]郑州大学公共卫生学院环境卫生学教研室,郑州450001 [2]河南省生殖健康科学技术研究院,国家卫生健康委员会出生缺陷预防重点实验室,郑州450002

出　　处：《郑州大学学报（医学版）》2022年第5期599-603,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(82003401,81972981);河南省科技攻关项目(202102310622);国家卫生健康委员会出生缺陷预防重点实验室开放课题(ZD202205)。

摘　　要：目的:探讨黄河沿岸河南农村地区母亲孕期大气污染物暴露对早产的潜在影响。方法:基于国家免费孕前优生健康检查项目,收集黄河沿岸河南农村地区2015~2018年孕妇及其单胎活产新生儿数据275380份。收集并整理该地区2015~2018年大气环境监测数据。利用Logistic回归模型探究孕期大气污染物暴露与早产的关系。结果:早产风险随孕妇总孕期PM_(10)(OR=1.165,95%CI:1.150~1.181)、PM_(2.5)(OR=1.312,95%CI:1.287~1.337)、SO_(2)(OR=1.513,95%CI:1.487~1.538)、NO_(2)(OR=1.721,95%CI:1.677~1.765)、CO(OR=1.246,95%CI:1.237~1.256)暴露水平升高而升高;随总孕期O_(3)暴露水平升高而降低(OR=0.789,95%CI:0.766~0.813)。孕早、孕中、孕晚期污染物暴露水平与早产风险的关系与总孕期相似。与暖季怀孕的母亲相比,冷季怀孕的母亲早产发生风险更易受孕期CO、NO_(2)、SO_(2)、PM_(10)和PM_(2.5)暴露的影响(P_(交互)<0.001),更不易受孕期O_(3)暴露的影响(P_(交互)=0.016)。结论:黄河沿岸河南农村地区孕妇孕期PM_(10)、PM_(2.5)、SO_(2)、NO_(2)、CO暴露可增加早产风险,O_(3)暴露会降低早产风险;怀孕季节可修饰孕期大气污染物暴露与早产的关系。Aim:To explore the association between prenatal air pollution exposure and the risk of preterm birth(PTB)in rural Henan along the Yellow River.Methods:A total of 275380 medical records during 2015-2018 based on the National Free Preconception Health Examination Project in rural Henan along the Yellow River were collected.Atmospheric environment minitoring date at the same period were also collected.Logistic regression analysis was conducted to estimate the association between air pollution exposure and the risk of PTB.Results:Exposure to PM_(10),PM_(2.5),SO_(2),NO_(2),and CO during the entire pregnancy increased the risk of PTB with adjusted OR(95%CI)of 1.165(1.150-1.181),1.312(1.287-1.337),1.513(1.487-1.538),1.721(1.677-1.765),and 1.246(1.237-1.256),respectively(P<0.05).Exposure to O_(3)during the entire pregnancy reduced the risk of PTB with adjusted OR(95%CI)of 0.789(0.766-0.813).Stratified analysis showed that the risk of PTB increased with the increase of PM_(10),PM_(2.5),SO_(2),NO_(2),and CO exposure,and the decrease of O_(3)exposure during different trimesters of pregnancy.PTB risk for mothers who conceived in cold seasons were more sensitive to the CO,NO_(2),SO_(2),PM_(10)and PM_(2.5)exposure(P_(interaction_<0.001),and less sensitive to the O_(3)exposure(P_(interaction)=0.016).Conclusion:Exposure to PM_(10),PM_(2.5),SO_(2),NO_(2)and CO during pregnancy may increase the risk of PTB and exposure to O_(3)may decrease the risk of PTB in rural Henan along the Yellow River,and the conception season can modify such relationship.

关 键 词：早产 大气污染 黄河沿岸 河南省 

分 类 号：R122.7[医药卫生—环境卫生学]