妊娠期大气污染复合暴露与新生儿发育关系的前瞻性出生队列研究  

Association of prenatal exposure to mixed air pollutants with placental and fetal development:a prospective birth cohort study

作　　者：余斯文 朱启炯 陈芷清 杨尚峰 何冠豪 马文军 刘涛[1] YU Si-wen;ZHU Qi-jiong;CHEN Zhi-qing;YANG Shang-feng;HE Guan-hao;MA Wen-jun;LIU Tao(Department of Public Health and Preventive Medicine,School of Medicine,Jinan University/China Greater Bay Area Research Center of Environmental Health,Jinan University,Guangzhou 510632,China)

机构地区：[1]暨南大学基础医学与公共卫生学院/暨南大学粤港澳大湾区环境健康研究中心,广州510632

出　　处：《环境卫生学杂志》2024年第3期185-193,共9页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：国家自然科学基金项目(42175181,42375180);广东省自然科学基金项目(2019A1515011264);科技部外国专家项目(G2022199006L)。

摘　　要：目的研究孕妇妊娠期大气污染复合暴露与胎盘及新生儿发育情况之间的暴露反应关系。方法基于2016—2017年在广州市开展的前瞻性出生队列研究收集孕妇及其胎盘和胎儿信息。运用分位数g计算(Qg-comp)模型估计大气污染混合物暴露对胎盘生长发育指标(重量、体积和胎盘体重比)和新生儿出生体重的联合效应,探索暴露敏感窗口及敏感人群。结果所有研究对象的胎盘重量、胎盘体积、胎盘体重比和新生儿出生体重■分别为(524.10±66.50)g、(730.10±186.40)cm^(3)、16.94%±3.40%和(3154.07±448.41)g。孕早期大气污染复合暴露与胎盘重量(β=-5.34 g,95%CI:-9.64 g~-1.04 g)、胎盘体积(β=-13.16 cm^(3),95%CI:-24.73 cm^(3)~-1.60 cm^(3))呈负相关,但是孕晚期复合暴露与胎盘重量(β=7.76 g,95%CI:1.78 g~13.73 g)和胎盘体重比(β=0.50%,95%CI:0.20%~0.80%)呈正相关。分层分析结果显示,在冷季受孕的孕妇的胎盘体重比(β=0.55%,95%CI:0.31%~0.79%)和新生儿出生体重(β=-54.87 g,95%CI:-91.02 g~-18.72 g)与污染物复合暴露的关系更加明显,而对于暖季受孕的孕妇,污染物暴露也会使其胎盘重量(β=-4.80 g,95%CI:-9.11 g~-0.50 g)和胎盘体重比(β=-0.26%,95%CI:-0.49%~-0.03%)减小;孕期增重不足孕妇的胎盘体重比(β=0.53%,95%CI:0.02%~1.05%)和新生儿出生体重(β=-98.94 g,95%CI:-172.79 g~-25.09 g)更容易受到混合污染物的影响。结论妊娠早期大气污染复合暴露与胎盘重量和胎盘体积呈负向关联,妊娠晚期污染物暴露与胎盘重量及胎盘体重比呈正向关联。不同受孕季节和孕期增重不足的孕妇的胎盘和胎儿都会受到污染物影响。Objective To investigate the exposure-response relationship between prenatal exposure to mixed air pollutants and placental and fetal development.Methods Based on the information on pregnant women and their placentas and newborns from a pro-spective birth cohort study conducted in Guangzhou,China from 2016 to 2017.Quantile g-computation was applied to assess the com-bined effects of prenatal exposure to mixed air pollutants on placental development indicators(placental weight,placental volume,and placental weight ratio[the ratio of placental weight to neonatal weight at birth])and neonatal birth weight,and explore the sensitive windows and vulnerable populations for prenatal exposure.Results The values of mean±standard deviation of placental weight,pla-cental volume,placental weight ratio,and neonatal birth weight for all participants were(524.10±66.50)g,(730.10±186.40)cm^(3),16.94%±3.40%,and(3154.07±448.41)g,respectively.Early prenatal exposure to mixed air pollutants was negatively associated with placental weight(β=-5.34 g,95%confidence interval[CI]:-9.64 g to-1.04 g)and placental volume(β=-13.16 cm^(3),95%CI:-24.73 cm^(3) to-1.60 cm^(3)),but late prenatal exposure to the mixture was positively associated with placental weight(β=7.76 g,95%CI:1.78 g to 13.73 g)and placental weight ratio(β=0.50%,95%CI:0.20%to 0.80%).According to the stratified analyses,for pregnant women who conceived in the cold season,there were stronger associations of pollutant mixture exposure with pla-cental weight ratio(β=0.55%,95%CI:0.31%to 0.79%)and neonatal birth weight(β=-54.87 g,95%CI:-91.02 g to-18.72 g);for those who conceived during the warm season,pollutant mixture exposure also decreased placental weight(β=-4.80 g,95%CI:-9.11 g to-0.50 g)and placental weight ratio(β=-0.26%,95%CI:-0.49%to-0.03%).For pregnant women who gained inadequate weight during pregnancy,placental weight ratio(β=0.53%,95%CI:0.02%to 1.05%)and neonatal birth weight(β=-98.94 g,95%CI:-172.79 g to-25.09 g)were more susceptible to pollutant mixture

关 键 词：大气污染 复合暴露 胎盘形态学指标 出生体重 

分 类 号：R1[医药卫生—公共卫生与预防医学] R12