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。
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.
关键词
大气污染 /
PM10 /
SO2 /
NO2 /
早产 /
时间序列
Key words
air pollution /
PM10 /
SO2 /
NO2 /
preterm birth /
time-series
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