摘要
目的 探讨空气中粒径≤2.5μm的颗粒物（PM2.5）对早产的影响情况。方法 以受孕日期在2013年1月1日至12月31日之间、山西医科大学第一医院妇产科分娩的太原市区1882例产妇作为研究对象。按照WHO对早产的定义,将研究对象分为早产组和足月产组,关联性分析时再将早产组分为轻度早产组、早期早产和极早早产组。收集其一般人口学特征资料、健康状况、分娩情况、家庭准确住址等资料;收集太原市8个监测点2013年1月1日至2014年10月10日PM2.5日平均浓度,根据反距离加权法计算孕妇孕期每天PM2.5暴露浓度,通过多因素非条件logistic回归模型分析PM2.5对早产的影响情况。结果 1839例产妇的早产发生率为8.21%（151/1839）。调整孕妇年龄、孕妇文化程度、孕前BMI等因素后结果显示,在分娩前第2周PM2.5浓度暴露值每增加10μg/m^3,早产风险增加8.7%（OR=1.087,95%CI：1.001-1.182）,轻度早产风险增加9.9%（OR=1.099,95%CI：1.007-1.200）。分娩前第2周孕妇处于PM2.5高水平环境（≥75μg/m^3）中,早产风险增加0.8%（OR=1.008,95%CI：1.000-1.017）,轻度早产风险增加1.0%（OR=1.010,95%CI：1.001-1.018）。结论 孕妇在孕晚期尤其是在分娩前半个月,PM2.5高浓度暴露会导致早产风险增加。
Objective To investigate the association between ambient fine particulate matter with aerodynamic diameter less than 2.5μm（PM2.5） and the risk on preterm birth. Methods A total of 1882 pregnant women with local residency of Taiyuan city and underwent delivery at the First Hospital of Shanxi Medical University with the dates of conception between January 1 and December 31, 2013, were enrolled in the study. Information on general demographics, home address and history on pregnancy, lifestyle and related environmental factors were collected through in-person interview. Birth outcomes and maternal complications were abstracted from medical records. Data on the amount of daily average PM2.5 from 8 monitor points in Taiyuan city, between March 1, 2012 and December 31, 2013 were also collected. Individual exposure during pregnancy were calculated using the inverse-distance weighting method, based on home address. Multivariate unconditional logistic regression model was used to examine the associations among PM2.5 exposure, risk of preterm birth and related clinical subtypes. Results The overall incidence of preterm birth was 8.21%（151/1839）in 1839 pregnant women. Exposure to ambient PM2.5 during the second week prior to delivery was associated with an increased risk of preterm birth（OR=1.087, 95%CI：1.001-1.182 per 10μg/m^3 increase） and mild preterm birth（OR=1.099, 95%CI：1.007-1.200 per 10μg/m^3）. Compared to data from the China Environmental Air Quality Standard, higher level of exposure（≥75μg/m^3） of PM2.5 during the second week before delivery was associated with an increased risk of preterm birth（OR=1.008, 95%CI：1.000-1.017） but the association was mainly seen for mild preterm birth（OR=1.010, 95%CI：1.001-1.018）. Conclusions Results from our study showed that exposure to high level of PM2.5 during late pregnancy would increase the risk of preterm birth. Future large studies are needed to examine the association by preterm clinical subtypes and to elucidate potential underlying mechanisms.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2016年第4期572-577,共6页
Chinese Journal of Epidemiology
基金
山西医科大学十人计划项目
山西省青年科技研究基金（2013021033-2）
山西省普通高校特色重点学科建设项目
国家自然科学基金（81473061）
关键词
空气污染
早产
反距离加权法
Air pollution
Preterm birth
Inverse-distance weighting
