摘要
目的 探讨孕期各阶段PM2.5 暴露与足月低体重儿发生风险的关系.方法 收集 2015 年 9 月 1 日至2017 年 12 月 31 日在河北省 22 个危重孕产妇监测点分娩的 118 783 名孕产妇住院资料,并收集其孕期各阶段的空气质量监测数据;根据足月新生儿是否低体重儿,将其分为足月低体重儿组和足月非低体重儿组,比较两组的孕期PM2.5 暴露情况,采用logistic回归模型分析其对足月低体重儿患病的影响.结果 足月低体重儿组孕期各阶段PM2.5 暴露水平明显高于足月非低体重儿组(P<0.05);妊娠期暴露于PM2.5 会增加足月低体重儿的发生风险;全孕期、孕早期、孕中期、孕晚期PM2.5 暴露浓度每增加 10 μg/m3,足月低体重儿的发生风险分别增加 4.9％、1.6％、1.7％、1.5％;高龄妊娠、低龄妊娠、产检次数少、初产、多产次(产次≥2)、多胎妊娠、胎儿女性、孕妇患妊娠高血压疾病、前置胎盘、胎盘早剥、心脏病均为足月低体重儿的独立危险因素(P<0.05).结论 妊娠期高浓度PM2.5 暴露会显著增加足月低体重儿的发生风险,应注意做好孕期防护.
Abstract
Objective To explore the association between PM2.5 exposure at various stages of pregnancy and the risk of full-term low birth weight infants.Methods The hospitalization data of 118 783 critically ill pregnant women who gave birth at 22 monitoring points in Hebei Province from September 1,2015 to December 31,2017,and air quality monitoring data for each stage of pregnancy were collected.According to whether the full-term newborn was a low birth weight infant,the total population was divided into a full-term low birth weight infant group and a full-term non-low birth weight infant group.The PM2.5 exposure during pregnancy between the two groups was compared,and the impact on the disease of full-term low birth weight infants was analyzed using a logistic regression model.Results The PM2.5 exposure levels at all stages of pregnancy in the full-term low birth weight infant group were significantly higher than those in the full-term non-low birth weight infant group(P<0.05).Exposure to PM2.5 during pregnancy increases the risk of full-term low birth weight infants.Every increase of 10 μg/m3 in PM2.5 exposure concentrations during full pregnancy,early pregnancy,mid-pregnancy,and late pregnancy increased the risk of full-term low birth weight infants by 4.9％,1.6％,1.7％,and 1.5％,respectively.Older pregnancy,younger pregnancy,fewer prenatal examinations,first birth,multiple births(≥2 births),multiple pregnancies,female fetus,pregnant women suffering from hypertensive disorder complicating pregnancy,placenta praevia,placental abruption,and heart disease are all independent risk factors for full-term low birth weight infants(P<0.05).Conclusion Exposure to high concentrations of PM2.5 during pregnancy can significantly increase the risk of full-term low birth weight infants,and it is important to take precautions during pregnancy.
万方数据