Abstract: Objective To analyze the association between PM2.5 exposure in early and middle pregnancy and the cognitive-motor development of their offspring,and provide evidence for air pollution protection during pregnancy. Methods Totally 190 pregnant women who built cards and labored in Shanghai First Maternal and Infant Hospital during June 2014 and April 2015 were selected.Questionnaires were filled when they built cards in our hospital,which got the information of residential address,type of housing and floor distribution.The penetration model was used to transform outdoor atmospheric PM2.5 concentration into indoor PM2.5 exposure concentration as PM2.5 exposure level during pregnancy.The cognitive-motor development assessment of infants was conducted during the "42 day physical examination after postpartum" using "Ages and Stages Questionnaires-Third edition,ASQ-3".Two independent sample t-test and multi factor linear regression analysis were used to analyze the correlation between PM2.5 exposure and the cognition-motor development of their offspring. Results During the first trimester of pregnancy,scores of gross motor and fine motor of infants in normal exposure group were higher than those in exceeded exposure group,as well as the total ASQ-3 score.The differences were statistically significant (P<0.05).PM2.5 exposure level during the first trimester of pregnancy increased each one unit,the scores of each aspect in ASQ-3 decreased 0.53~0.62 points,the total score of ASQ-3 decreased by 2.0 points.In the second trimester,the PM2.5 exposure's effect was different.Although the PM2.5 exposure's level in the second trimester of pregnancy also showed a tendency of decreasing the ASQ-3 score,however,the difference was not statistically significant (P>0.05). Conclusions Compared with PM2.5 exposure in the second trimester of pregnancy,the PM2.5 exposure during the first trimester of pregnancy makes a more serious impact on the cognition-motor development of their offspring.So the protection for atmospheric pollution should focus on the early stages of pregnancy.

Key words: pregnancy, PM2.5 exposure, infant, cognitive-motor development

摘要： 目的 分析孕早期和孕中期PM2.5暴露与子代认知-运动发育间关联性,为孕期防护提供依据。方法 选取2014年6月-2015年4月期间来本院建卡并分娩的孕妇190例,于孕期建卡时进行问卷调查,获取孕妇的居住地址、房屋类型以及楼层分布等信息,通过渗透系数获得室外PM2.5进入室内部分的浓度,作为孕期PM2.5暴露水平。并于婴儿产后42 d体检时应用“年龄发育进程问卷-第三版”(ASQ-3)进行认知-运动发育水平评估。通过两独立样本t检验和多因素线性回归等方法分析孕期PM2.5暴露与子代认知-运动发育间的关联性。结果 孕早期正常暴露组孕妇所生婴儿粗大运动能区得分和精细运动能区得分均高于暴露超标组婴儿,且正常暴露组婴儿五个能区总分也高于暴露超标组婴儿,差异均有统计学意义(P<0.05)。孕早期孕妇暴露PM2.5水平每增高一个单位,ASQ-3各能区得分平均降低0.53~0.62分,ASQ-3总分平均降低2.0分,且以上差异有统计学意义(P<0.05)。与孕早期的PM2.5暴露效应不同,在孕中期虽然PM2.5暴露水平增高也呈现出ASQ-3多能区得分降低的趋势,但差异无统计学意义(P>0.05)。结论 相对于孕中期的PM2.5暴露,孕早期的暴露更容易对子代认知-运动发育水平产生影响,因此针对大气PM2.5的防护应从孕早期就开始并且应重点做好孕早期的暴露防护。

关键词: 孕期, PM2.5暴露, 婴儿, 认知-运动发育