文章摘要
郭乐倩,章琦,赵豆豆,王玲玲,陈宇,米白冰,党少农,颜虹.孕期空气污染物暴露与活产单胎新生儿出生体重的关联性分析[J].中华流行病学杂志,2017,38(10):1399-1403
孕期空气污染物暴露与活产单胎新生儿出生体重的关联性分析
Relationship between air pollution exposure during pregnancy and birth weight of term singleton live-birth newborns
收稿日期:2017-02-15  出版日期:2017-10-23
DOI:10.3760/cma.j.issn.0254-6450.2017.10.021
中文关键词: 出生体重;空气污染;气象条件
英文关键词: Birth weight;Air pollution;Meteorological factors
基金项目:国家自然科学基金(81230016)
作者单位E-mail
郭乐倩 710061 西安交通大学医学部公共卫生学院流行病与卫生统计学系  
章琦 710061 西安交通大学医学部公共卫生学院流行病与卫生统计学系  
赵豆豆 710061 西安交通大学医学部公共卫生学院流行病与卫生统计学系  
王玲玲 710061 西安交通大学医学部公共卫生学院流行病与卫生统计学系  
陈宇 718000 榆林市第一医院病案科  
米白冰 710061 西安交通大学医学部公共卫生学院流行病与卫生统计学系  
党少农 710061 西安交通大学医学部公共卫生学院流行病与卫生统计学系  
颜虹 710061 西安交通大学医学部公共卫生学院流行病与卫生统计学系 yanhonge@mail.xjtu.edu.cn 
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中文摘要:
      目的 应用多元线性模型探讨孕期不同空气污染暴露与出生体重之间的关联性。方法 采用多阶段随机抽样方法,自行设计问卷调查2010-2013年西安市曾经怀孕的育龄妇女及其生育子女,最终共纳入4 631例产妇。污染数据和气象资料由常规监测数据整理获得。根据母亲孕周和分娩日期计算孕妇各孕期污染物个体暴露水平。分别以不同孕期空气污染暴露(单污染物、双污染物、三污染物)和子女出生体重作为自变量和因变量,通过逐步校正混杂因素共建立3个多元线性模型,其中模型一仅分析空气污染暴露变量,模型二在模型一的基础上进一步校正母亲及新生儿个体差异因素,模型三在模型二的基础上进一步校正气象因素。结果 不同性别、孕周、母亲生育年龄、母亲文化程度、户籍、家庭经济情况分组的婴儿,其出生体重差异有统计学意义(P<0.01)。考虑污染物的协同作用后,模型一的差异无统计学意义(P>0.05),孕中期接触NO2的平均浓度每增加10 μg/m3,出生体重会减少13.3 g(模型二减少10.9 g),接触PM10每增加10 μg/m3,出生体重减少6.6 g(模型二减少5.9 g);孕晚期接触NO2每增加10 μg/m3,出生体重减少13.7 g(模型二减少9.8 g)。结论 控制气象因素后,孕中期NO2、PM10的暴露水平以及孕晚期NO2的暴露对婴儿出生体重具有负效应。
英文摘要:
      Objective This study explored the association between air pollution exposure and birth weight by using the multilevel linear model, after controlling related meteorological factors and individual differences of both mothers and babies. Methods Women of childbearing age who were pregnant in Xi'an from 2010 to 2013, were selected as objects of this study. Multistage random sampling method was used to select 4 631 subjects followed by a self-designed questionnaire survey.Data related to quality of air and meteorology were gathered from routine monitoring system. Gestational age and date of birth, together with the average levels of air pollution were calculated for each trimester on each mother, and then the impact of air pollution on birth weight was assessed. A multilevel linear model was employed to investigate the association between the levels of exposure to air pollution by birth weight. Confounding factors were under control. We established three models in this study:Model 1 which involving the variable of air pollution exposure. Model 2 was adjusted for variables in Model 1 plus some other individual differences of both mother and baby. Model 3 was adjusted for variables in Model 2 plus meteorological factors. Results There were significant differences seen in birth weight within the subgroups of gender, gestational age, mother's reproductive age, maternal education, residential areas and family incomes (P<0.01) of the infants. However, there was no difference found in Model 1 (P>0.05). Data from Model 3 indicated that a decrease of 13.3 g (10.9 g in Model 2) and 6.6 g (5.9 g in Model 2) in birth weight that were associated with an increase of 10 μg/m3 in the average level of NO2 and PM10 during the second trimester; A decrease of 13.7 g (9.8 g in Model 2) in birth weight was associated with an increase of 10 μg/m3 in the average level of NO2 during the third trimester. Conclusion After controlling for meteorological factors, the levels of exposure to NO2 and PM10 during the second trimester and NO2 during the third trimester were negatively associated with birth weight.
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