孕期空气污染物暴露与早产的相关性研究  

Study on the correlation between exposure to air pollutants during pregnancy and preterm birth

作　　者：蒋如霞 刘霞 徐敏慧 JIANG Ruxia;LIU Xia;XU Minhui(Department of Neonatology,Meishan Maternal and Child Health Hospital,Sichuan Meishan 620010,China)

机构地区：[1]眉山市妇幼保健院新生儿科,四川眉山620010

出　　处：《中国妇幼健康研究》2025年第4期71-77,共7页Chinese Journal of Woman and Child Health Research

摘　　要：目的探索孕期空气污染物暴露与早产发生的相关性,为早产的预防提供支持。方法采用病例对照研究设计,选取2022年1月至2023年12月在眉山市妇幼保健院出生的135例早产儿作为病例组,以同期出生的135例足月儿作为对照组。收集两组孕妇的基本信息和2021年1月至2023年12月各污染物(包括PM_(2.5)、PM_(10)、SO_(2)、NO_(2)、O 3和CO)的日平均浓度,计算孕期各阶段的平均空气污染物浓度,包括整个孕期(孕期平均)、孕前三个月(孕前三月平均)、孕早期(孕12周以内平均)、孕中期(孕13~28周平均)和孕晚期(孕29周以后平均)。采用多元逻辑回归分析评估孕期空气污染物暴露与早产的相关性。结果病例组孕妇在整孕期、孕前三个月、孕早期、孕中期和孕晚期的PM_(2.5)、PM_(10)、SO_(2)、NO_(2)的平均空气污染物暴露水平均显著高于对照组孕妇,t值范围分别为2.52~3.22、2.57~3.09、2.40~2.96、2.44~2.87、2.38~2.78(P<0.05)。整个孕期暴露于较高水平的PM_(2.5)、SO_(2)、NO_(2)与发生早产的风险增加显著相关(P<0.05),而PM_(10)、O 3和CO对早产发生的影响尚未发现统计学意义(P>0.05)。与孕期平均PM_(2.5)暴露浓度<46.0μg/m 3组相比,孕期平均PM_(2.5)暴露浓度在>69.0μg/m 3组的孕妇早产风险显著增加(OR=1.86,95%CI:1.09~3.17);与孕期平均SO_(2)暴露浓度<13.0μg/m 3组相比,孕期平均SO_(2)暴露浓度在>19.0μg/m 3组的孕妇早产风险显著增加(OR=1.76,95%CI:1.04~2.99);与孕期平均NO_(2)浓度<40.0μg/m 3组相比,孕期平均NO_(2)浓度在>60.0μg/m 3组的孕妇早产风险显著增加(OR=1.82,95%CI:1.08~3.07)。结论孕期暴露于较高浓度的空气污染物可能是早产发生的重要危险因素之一,提示应关注空气污染,以保护胎儿健康。Objective To explore the association between air pollutant exposure during pregnancy and the occurrence of preterm birth to support the prevention of preterm birth.Methods A case-control study was designed to select 135 preterm infants born in Meishan Maternal and Child Health Hospital from January 2022 to December 2023 as the case group,and 135 full-term infants born during the same period as the control group.The basic information of the two groups of pregnant women and the daily average air pollutant concentrations of each pollutant(including PM_(2.5),PM_(10),SO_(2),NO_(2),O_(3) and CO)from January 2021 to December 2023 were collected,and the average air pollutant concentrations at each stage of pregnancy were calculated,including the whole pregnancy period(pregnancy average),the first trimester of pregnancy(the average of three months before pregnancy),the first trimester(the average of less than 12 weeks of pregnancy),the second trimester(the average of 13~28 weeks of pregnancy)and the third trimester(the average after 29 weeks of pregnancy).Multiple logistic regression analysis was used to evaluate the association between exposure to air pollutants during pregnancy and preterm birth.Results The average exposure levels of PM_(2.5),PM_(10),SO_(2) and NO_(2) in the whole pregnancy,first trimester,first trimester,second trimester and third trimester of pregnancy were significantly higher than those in the control group(t values ranged from 2.52-3.22,2.57-3.09,2.40-2.96,2.44-2.87,and 2.38-2.78,respectively,P<0.05).Exposure to higher levels of PM_(2.5),SO_(2) and NO_(2) was significantly associated with an increased risk of preterm birth throughout pregnancy(P<0.05),while the effects of PM_(10),O_(3) and CO on the occurrence of preterm birth were not s tatistically significant(P>0.05).Compared with the average PM_(2.5) exposure concentration of<46.0μg/m^(3) during pregnancy,the risk of preterm birth was significantly higher in the>69.0μg/m^(3) group(OR=1.86,95%CI:1.09-3.17).Compared with the<13.0μg/m^(3) group

关 键 词：空气污染物 暴露 早产 病例对照研究 

分 类 号：R173[医药卫生—妇幼卫生保健]