目的 分析孕期室外空气污染暴露与新生儿呼吸窘迫综合征(NRDS)的相关性,为NRDS新生儿规范化管理提供参考依据。方法 收集2013年1月—2020年12月北京市中日友好医院的新生儿住院资料及孕母居住地主要空气污染物资料,采用Logistic回归模型分析母亲孕期空气污染暴露对NRDS的影响,回归交互效应分析性别差异。结果 孕期室外空气污染物CO与PM2.5暴露均与新生儿NRDS风险增加有关(CO:OR孕早期=1.39, 95%CI:1.06～1.81、OR孕中期=1.77, 95%CI:1.34～2.35、OR孕晚期=1.38, 95%CI:1.05～1.80;PM2.5:OR孕早期=1.41, 95%CI:1.01～1.81、OR孕中期=1.49, 95%CI:1.16～1.91、OR孕晚期=1.56, 95%CI:1.21～2.01,P＜0.05)。PM10暴露与新生儿NRDS风险增加仅见于孕中、晚期(OR孕中期=1.31,95%CI:1.02～1.69、OR孕晚期=1.32, 95%CI:1.04～1.69,P＜0.05)。性别分析中围生期室外空气污染暴露在不同性别新生儿间无交互作用。结论 孕期CO、PM2.5以及PM10会增加NRDS风险。在围生期的预防工作中,要及时关注空气污染变化,开展针对性的防控措施。
Abstract
Objective To analyze the correlation between outdoor air pollution exposure during pregnancy and neonatal respiratory distress syndrome(NRDS), in order to provide reference for standardized management of NRDS in newborns. Methods Data on neonatal hospitalizations and major air pollutants at the residence of pregnant mothers from January 2013 to December 2020 were retrospectively collected at the China-Japan Friendship Hospital in Beijing. Logistic regression models were used to analyze the impact of maternal air pollution exposure during pregnancy on NRDS, and the gender differences were analyzed by regression interaction effect. Results Exposure to both outdoor air pollutants CO and PM2.5 during pregnancy was associated with an increased risk of neonatal NRDS(CO: OR first trimester =1.39, 95%CI:1.06 - 1.81, ORsecond trimester =1.77, 95%CI:1.34 - 2.35, ORthird trimester =1.38, 95%CI:1.05 - 1.80; PM2.5: ORfirst trimester =1.41, 95%CI:1.01 - 1.81, ORsecond trimester =1.49, 95%CI:1.16 - 1.91, ORthird trimester =1.56, 95%CI:1.21 - 2.01)(P<0.05). PM10 exposure was associated with an increased risk of neonatal NRDS only in the second and third trimester(ORsecond trimester=1.31, 95%CI:1.02 - 1.69, ORthird trimester =1.32, 95%CI:1.04 - 1.69)(P<0.05). Gender analysis showed no interaction between perinatal exposure to outdoor air pollution among newborns of different genders. Conclusions Exposure to CO, PM2.5, and PM10 during pregnancy increases the risk of NRDS. In the prevention work of perinatal period, timely attention should be given to changes in air pollution, and targeted prevention and control measures should be implemented.
关键词
孕期 /
空气污染暴露 /
新生儿呼吸窘迫综合征
Key words
pregnancy period /
air pollution exposure /
neonatal respiratory distress syndrome
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Negi R, Pande D, Karki K, et al. A novel approach to study oxidative stress in neonatal respiratory distress syndrome[J]. BBA Clin, 2015, 3: 65-69.
[2] Rubarth LB, Quinn J. Respiratory development and respiratory distress syndrome[J]. Neonatal Netw, 2015, 34(4): 231-238.
[3] Nemery B, Hoet PH, Nemmar A. The meuse valley fog of 1930: An air pollution disaster[J].Lancet, 2001, 357(9257): 704-708.
[4] Cocchi E, Bellisario V, Cresi F, et al. Air pollution and aeroallergens as possible triggers in preterm birth delivery[J]. Int J Environ Res Public Health, 2023, 20(2): 1610.
[5] Ha S, Martinez V, Chan-Golston AM. Air pollution and preterm birth: A time-stratified case-crossover study in the San Joaquin Valley of California[J].Paediatr Perinat Epidemiol, 2022, 36(1): 80-89.
[6] Gong X, Huang Y, Duong J, et al. Industrial air pollution and low birth weight in New Mexico, USA[J]. J Environ Manage, 2023, 348: 119236.
[7] Wesselink AK, Kirwa K, Hystad P, et al. Ambient air pollution and rate of spontaneous abortion[J]. Environ Res, 2024, 246: 118067.
[8] Sun Q, Chen Y, Ye F, et al. Association of hypothyroidism during pregnancy with preconception and early pregnancy exposure to ambient particulate matter[J].Environ Sci Pollut Res Int, 2023, 30(37): 88084-88094.
[9] 江载芳,申昆玲,沈颖.诸福棠实用儿科学[J].8版.北京:人民卫生出版社.
Jiang ZF,Shen KL,Sheng Y.Zhu Futang practice of pediatircs[J]. 8th edition.Beijing:People′s Medical Publishing House.
[10] Wei J, Li Z, Xue W, et al. The China high PM(10) dataset: Generation, validation, and spatiotemporal variations from 2015 to 2019 across China[J]. Environ Int, 2021, 146: 106290.
[11] Jones SI, Pruszynski JE, Spong CY, et al. Traffic-related air pollution is associated with spontaneous extremely preterm birth and other adverse perinatal outcomes[J]. Am J Obstet Gynecol, 2023, 229(4): 455.e1-455.e7.
[12] Flanagan E, Oudin A, Walles J, et al. Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia[J]. Environ Int, 2022, 164: 107251.
[13] Zhou W, Ming X, Yang Y, et al. Associations between maternal exposure to ambient air pollution and very low birth weight: A birth cohort study in Chongqing, China[J]. Front Public Health, 2023, 11: 1123594.
[14] Yang S, Tan Y, Mei H, et al. Ambient air pollution the risk of stillbirth: A prospective birth cohort study in Wuhan, China[J]. Int J Hyg Environ Health, 2018, 221(3): 502-509.
[15] Decrue F, Gorlanova O, Salem Y, et al. Increased impact of air pollution on lung function in preterm versus term infants: The BILD study[J]. Am J Respir Crit Care Med, 2022, 205(1): 99-107.
[16] Kannan S, Misra DP, Dvonch JT, et al. Exposures to airborne particulate matter and adverse perinatal outcomes:A biologically plausible mechanistic framework for exploring potential effect modification by nutrition[J]. Environ Health Perspect, 2006, 114(11): 1636-1642.
[17] Laumbach RJ. Outdoor air pollutants and patient health[J]. Am Fam Physician, 2010, 81(2): 175-180.
[18] Wang F, Liu J, Zeng H. Interactions of particulate matter and pulmonary surfactant: Implications for human health[J]. Adv Colloid Interface Sci, 2020, 284: 102244.
[19] Ling X. The effect of ambient air pollution on birth outcomes in Norway[J]. BMC Public Health, 2023, 23(1): 2248.
[20] Liao J, Zhang Y, Yang Z, et al. Identifying critical windows of air pollution exposure during preconception and gestational period on birthweight: A prospective cohort study[J]. Environ Health, 2023, 22(1): 71.
[21] Pereira G, Bracken MB, Bell ML. Particulate air pollution, fetal growth and gestational length: The influence of residential mobility in pregnancy[J]. Environ Res, 2016, 147: 269-274.
基金
出生人口健康教育部重点实验室开放课题(JK20225)
PDF(1121 KB)
