上海市徐汇区大气污染物与新生儿早产的关联性研究

doi:10.11852/zgetbjzz2017-25-10-06

摘要/Abstract

摘要： 目的本研究旨在分析上海市徐汇区大气污染物对早产发生的影响,定量评估不同大气污染物(PM₁₀、SO₂、NO₂)对早产发生的影响。方法根据时间序列研究方法,采用过分散的广义相加模型(GAM),在控制时间平滑趋势、气温、气湿和星期几效应等混杂因素后,分析PM₁₀、SO₂、NO₂和每日早产发生数的关联。结果对于不同污染物来说,PM10仅在累积暴露为产前1周时,对早产发生的影响有统计学意义,PM₁₀每升高10 μg/m³,早产发生率上升1.868%(95%CI0.339%~3.397%);NO₂在累积暴露为产前1、2和3周时,对早产发生的影响均有统计学意义,NO₂每升高10 μg/m³,早产发生率分别上升6.214%(95%CI2.294%~10.134%)、7.098%(95%CI2.100%~12.096%)和6.498%(95%CI0.344%~12.652%);SO₂无论累积暴露为产前1、2、3周还是4周,对早产发生的影响均无统计学意义(P>0.05)。根据母亲年龄、胎数和是否出生畸形分层后,发现对于单胎、出生畸形、以及母亲年龄为≤24岁和≥35岁的层组来说,产前1周的PM₁₀平均浓度水平上升对早产发生有影响。产前1周的NO₂平均浓度水平和早产的发生,仅与母亲年龄≥35岁组有关。各层组均未观察到SO₂平均浓度水平的改变和早产发生的效应。3种污染物的单日滞后0~6 d(lag0~lag6)的急性期暴露效应,结果显示仅对于NO₂的lag4和lag5的滞后效应有统计学意义。结论大气污染物PM₁₀和NO₂对早产发生的影响有统计学意义,尤其是NO₂的累积暴露浓度滞后时间更长,且产前3周内的累积效应比产前7日的急性期滞后效应更有意义,研究中未发现SO₂对早产的影响。

关键词: 大气污染, PM₁₀, SO₂, NO₂, 早产, 时间序列

Abstract: Objectives To understand the association of air pollutants with preterm birth in Xuhui District and to quantitatively evaluate the effect of air pollutants (PM₁₀,SO₂,and NO₂) on preterm birth. Method A generalized additive model (GAM) was used to analyse the association of air pollutants (PM₁₀,SO₂,and NO₂) with preterm delivery after controlling confounders including the covariates of temperature,humidity and day of week (DOW). Results A significant effect of PM₁₀ was observed only in 1-week exposure before preterm birth.An increase of 10 μg/m3 of 1-week average PM₁₀ corresponded to 1.868% (95%CI:0.339%~3.397%) higher rate of preterm birth.NO₂,with 1-week,2-week and 3-week exposure before delivery,was statistically significant with preterm birth and with the NO₂ rising per 10 μg/m3,the incidence of preterm birth was up to 6.241%(95%CI:2.294% ~10.134%),7.098% (95%CI:2.100%~12.096%) and 6.498% (95%CI:0.344%~12.652%)respectively.Otherwise,SO₂ had no signficant impact on the premature occurrence.After stratified by maternal age,birth defects,and number of births,the stronger associations with PM₁₀ in the levels of single birth,infants who had birth defects,maternal age below 24 and over 34 years old,were considered.NO₂ was related to preterm birth only at the level of maternal age over 34 years old.The effect of SO₂ on premature was not observed within each group.Studies of acute effects were also overtaken.In the analysis of pollutants,only NO₂ with lag4 and lag5 exhibited an effect on preterm birth. Conclusions The influences of air pollutants PM₁₀ and NO₂ are statistically significant on preterm birth.The effect of exposure of 3 weeks before birth is more meaningful than acute effect.The impact of SO₂ on premature is not found.

Key words: air pollution, PM₁₀, SO₂, NO₂, preterm birth, time-series

中图分类号:

R179

王飞 ,陈仁杰,王现,顾海雁,阚海东. 上海市徐汇区大气污染物与新生儿早产的关联性研究[J]. 中国儿童保健杂志, 2017, 25(10): 993-997.

WANG Fei,CHEN Ren-jie,WANG Xian,GU Hai-yan,KAN Hai-dong. Association of ambient air pollutants with the risk of preterm birth in Xuhui District,Shanghai[J]. journal1, 2017, 25(10): 993-997.

0
/ / 推荐

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://manu41.magtech.com.cn/Jwk_zgetbjzz/CN/10.11852/zgetbjzz2017-25-10-06

https://manu41.magtech.com.cn/Jwk_zgetbjzz/CN/Y2017/V25/I10/993

参考文献

[1] Ritz B,Wilhelm M,Hoggatt K J,et al.Ambient air pollution and preterm birth in the environment and pregnancy outcomes study at the University of California,Los Angeles[J].Am J Epidemiol,2007,166(9):1045-1052.
[2] Wilhelmm RB.Local variations in CO and particulate air pollution and adverse birth outcomes in Los Angeles County,California,USA[J].Environ Health Perspect,2005,113(9):1212-1221.
[3] Basu R,Malig B,Ostro B.High ambient temperature and the risk of preterm delivery[J].Am J Epidemiol,2010,172(10):1108-1117.
[4] Strand L,Barnett A,Shilutong.Maternal exposure to ambient temperature and the risks of preterm birth and stillbirth in Brisbane,Australia[J].Am J Epidemiol,2012,175(2):99-107.
[5] Wolf J,Armstrong B.The association of season and temperature with adverse pregnancy outcome in two German States,a time-series analysis[J].PLos One,2012,7(7):e40228.
[6] Strand L,Barnett A,Shilutong.The influence of season and ambient temperature on birth outcomes[J].Environ Res,2011,111:451-462.
[7] 刘志祥,黄秀霞.孕前及孕期细颗粒物PM2.5对早产效应的因素分析[J].中国妇幼健康研究,2017,28(3):246-249.
[8] Brauer M,Lencar C,Tamburic L,et al.A cohort study of traffic-related air pollution impacts on birth outcomes[J].Environ Health Perspect,2008,116(5):680-686.
[9] Darrow L,Mitchel K,Flanders WD,et al.Ambient air pollution and preterm birth[J].Epidemiology,2009,20(5):689-698.
[10] 张燕萍,刘旭辉,任展宏,等.太原市大气污染对妊娠结局的影响[J].环境与健康,2007,24(3):128-131.
[11] 亚库甫·艾麦尔,王佳佳,彭振耀,等.北京市大气污染对不良妊娠结局影响的病例对照研究[J].环境与健康,2013,30(5):389-393.
[12] Ritz B,Fei Y,Chapa G,et al.Effect of air pollution on preterm birth among children born in southern California between 1989 and 1993[J].Epidemiology,2000,11(5):502-511.
[13] 陶瑞文,夏珣,黄锟,等.妊娠期空气颗粒物暴露与早产[J].中国公共卫生,2016,32(2):239-243.
[14] 杨敏娟,沈惠平,黄云彪,等.妊娠期大气污染暴露对早产影响的流行病学研究[J].职业与健康,2016,32(2):221-224.
[15] Liu SL,Krewski D,Shi YL,et al.Association between gaseous ambient air pollutants and adverse pregnancy outcomes in Vancouver,Canada[J].Environ Health Perspect,2003,111(14):1773-1778.
[16] Salam MT,Millstein J,Yf L,et al.Birth outcomes and prenatal exposure to ozone,Carbon monoxide,and particulate matter results from the Children's Health Study[J].Environmental Health Perspectives,2005,113(11):1638-1644.
[17] Sabrina L,Ferran B,Marisa E,et al.Preterm birth and exposure to air pollutants during pregnancy[J].Environ Health Perspect,2010,110(8):778-785.
[18] Jiang LL,Zhang YH,Song GX,et al.A time series analysis of outdoor air pollution and preterm birth in Shanghai[J].Biomed Environ Sci,2007,20(5):426-431.
[19] Schifano P,Lallo A,Asta F,et al.Effect of ambient temperature and air pollutants on the risk of preterm birth,Rome 2001–2010[J].Environ Int,2013,61:77-87.
[20] Radim JR,Binková B,Dejmek J,et al.Ambient air pollution and pregnancy outcomes-a review of the literature[J].Environ Health Perspect,2005,113(4):375-382.
[21] 王飞,阚海东,顾海雁,等.上海市徐汇区2006-2012年新生儿早产的危险因素分析[J].中国儿童保健杂志,2017,25(2):170-173.
[22] 张燕萍,张志琴,武永春,等.太原市空气污染对早产的急性影响[J].环境与健康,2008,25(3):194-197.
[23] Bing-fang H,Lee YL,Jaakkola JK.Air pollution and stillbirth:a Population-Based case–control study in Taiwan[J].Environ Health Perspect,2011,119(9):1345-1349.