| 黄磊,吕红,徐欣,孙天宇,陈逸源,张彦杰,杨波,陆群,蒋杨倩,蒋涛,杜江波,王晓艳,马红霞,胡志斌,林苑.妊娠期PM2.5暴露影响胎儿生长的前瞻性队列研究[J].Chinese journal of Epidemiology,2024,45(6):794-801 |
| 妊娠期PM2.5暴露影响胎儿生长的前瞻性队列研究 |
| Association between prenatal exposure to PM2.5 and fetal growth: a prospective cohort study |
| Received:January 31, 2024 |
| DOI：10.3760/cma.j.cn112338-20240131-00055 |
| KeyWord: 胎儿生长 PM2.5 组分 前瞻性队列 效应窗口 |
| English Key Word: Fetal growth PM2.5 Constituents Prospective cohort Critical windows |
| FundProject:国家重点研发计划（2021YFC2700705，2022YFC3702702）；国家自然科学青年基金（82103854）；江苏省自然科学基金青年基金（BK20210533） |
| Author Name | Affiliation | E-mail | | Huang Lei | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166,China | | | Lyu Hong | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002,China | | | Xu Xin | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166,China | | | Sun Tianyu | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China | | | Chen Yiyuan | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China | | | Zhang Yanjie | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China | | | Yang Bo | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China | | | Lu Qun | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166,China | | | Jiang Yangqian | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166,China | | | Jiang Tao | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166,China | | | Du Jiangbo | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002,China | | | Wang Xiaoyan | Department of Obstetrics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, China | | | Ma Hongxia | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002,China | | | Hu Zhibin | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002,China | | | Lin Yuan | State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, China
Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166,China
State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002,China | yuanlin@njmu.edu.cn |
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| Abstract: |
| 目的 探讨妊娠期PM2.5及其组分暴露对胎儿生长的影响，并进一步识别暴露效应窗口。方法 选取江苏出生队列2016年1月至2019年10月招募的4 089对母子对，收集其基线信息、妊娠期诊疗信息、妊娠期PM2.5及其组分暴露信息、妊娠满20周后的胎儿B超检查（头围、腹围、股骨长和估计体重）信息。利用广义线性混合模型进行暴露效应的估计，利用分布滞后非线性模型探讨暴露效应窗口。结果 妊娠期PM2.5暴露浓度每升高10 μg/m3，胎儿头围、腹围和估计体重Z评分分别减小0.025（β=-0.025，95%CI：-0.048~-0.001）、0.026（β=-0.026，95%CI：-0.049~-0.003）和0.028（β=-0.028，95%CI：-0.052~-0.004），头围和估计体重生长受限风险分别增加8.5%（RR=1.085，95%CI：1.010~1.165）和13.5%（RR=1.135，95%CI：1.016~1.268）。PM2.5组分中黑碳、有机物、硝酸盐、硫酸盐、铵盐暴露浓度升高均与头围Z评分减小显著相关，同时硫酸盐暴露的增加还与股骨长的Z评分减小有关。妊娠期PM2.5暴露影响胎儿头围生长效应窗口为第2~5周，腹围为第4~13周以及第19~40周，股骨长为第4~13周以及第23~37周，估计体重为第4~12周以及第20~40周。结论 妊娠期PM2.5及其组分暴露可能对胎儿生长产生不利影响，影响胎儿不同生长指标的效应窗口不完全一致。 |
| English Abstract: |
| Objective To investigate the association of exposure to PM2.5 and its constituents during pregnancy and fetal growth and to further identify critical windows of exposure for fetal growth. Methods We included 4 089 mother-child pairs from the Jiangsu Birth Cohort Study between January 2016 and October 2019. Data of general characteristics, clinical information, daily average PM2.5 exposure, and its constituents during pregnancy were collected. Fetal growth parameters, including head circumference (HC), abdominal circumference (AC), and femur length (FL), were measured by ultrasound after 20 weeks of gestation, and then estimated fetal weight (EFW) was calculated. Generalized linear mixed models were adopted to examine the associations of prenatal exposure to PM2.5andits constituents with fetal growth. Distributed lag nonlinear models were used to identify critical exposure windows for each outcome. Results A 10 μg/m3 increase in PM2.5 exposure during pregnancy was associated with a decrease of 0.025 (β=-0.025, 95%CI: -0.048- -0.001) in HC Z-score, 0.026 (β=-0.026, 95%CI: -0.049- -0.003) in AC Z-score, and 0.028 (β=-0.028, 95%CI:-0.052--0.004) in EFW Z-score, along with an increased risk of 8.5% (RR=1.085, 95%CI: 1.010-1.165) and 13.5% (RR=1.135, 95%CI: 1.016-1.268) for undergrowth of HC and EFW, respectively. Regarding PM2.5 constituents, prenatal exposure to black carbon, organic matter, nitrate, sulfate (SO42-) and ammonium consistently correlated with decreased HC Z-score. SO42- exposure was also associated with decreased FL Z-scores. In addition, we found that gestational weeks 2-5 were critical windows for HC, weeks 4-13 and 19-40 for AC, weeks 4-13 and 23-37 for FL, and weeks 4-12 and 20-40 for EFW. Conclusions Our findings demonstrated that exposure to PM2.5 and its constituents during pregnancy could adversely affect fetal growth and the critical windows for different fetal growth parameters are not completely consistent. |
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