孕前及孕期PM2.5及其化学组分暴露与大于胎龄儿发生风险的关联性研究OA
Associations of preconception and prenatal exposures to PM2.5 and its chemical components with risk of large-for-gestational age births
[背景]大于胎龄儿(LGA)与母婴不良结局及子代远期肥胖、代谢综合征及心血管疾病等风险增加相关.除传统危险因素外,孕前及孕期环境暴露,尤其是细颗粒物(PM2.5),可能在胎儿过度生长中发挥重要作用,但其化学组分差异及关键暴露时间窗尚不明确. [目的]评估孕前及孕期PM2.5 及其化学组分暴露与LGA发生风险之间的关联. [方法]基于 2010-2014年参加国家免费孕前优生健康检查项目的单胎妊娠女性,采用居住地址空间匹配评估孕前及孕期不同时间窗 PM2.5 及其化学组分暴露水平,运用广义线性模型和 qg-computation方法分析单一及混合污染物暴露与LGA发生风险的关联. [结果]PM2.5 及其主要化学组分暴露均与 LGA发生风险显著升高相关,且不同组分的效应强度存在差异.总体而言,二次无机气溶胶组分的健康效应更为突出.以全孕期暴露为例,硝酸盐(OR=1.330,95%CI:1.313～1.347)、铵盐(OR=1.279,95%CI:1.263～1.295)和硫酸盐(OR=1.242,95%CI:1.227～1.257)对 LGA发生风险的影响大于黑碳和有机物.暴露时间窗分析显示,孕前1个月和孕晚期是重要暴露窗口,而全孕期暴露效应最强,提示 PM2.5 及其组分暴露可能具有一定的时间累积效应.混合暴露分析进一步表明,在各时间窗内,硝酸盐和硫酸盐在PM2.5 组分联合效应中持续占据主要正向贡献地位. [结论]孕前及孕期 PM2.5 及其化学组分暴露与 LGA风险升高相关,其中硝酸盐和硫酸盐在不同妊娠阶段均表现出更稳定且较强的影响,提示 PM2.5 组分差异及暴露时间窗在胎儿过度生长中的重要性.
[Background]Large-for-gestational-age(LGA)births are associated with adverse perinatal out-comes and increased risks of offspring obesity,metabolic syndrome,and cardiovascular diseases later in life.Beyond traditional risk factors,exposure to environmental factors,especially fine particulate matter(PM2.5),before and during pregnancy may contribute to excessive fetal growth;however,the roles of specific chemical constituents and critical exposure windows remain unclear. [Objective]To examine the associations between maternal exposures to PM2.5 and its chemical constituents before and during pregnancy and the risk of delivering LGA infants. [Methods]Singleton pregnancies from the National Free Preconception Health Examination Project between 2010 and 2014 were included.Individual exposures to PM2.5 and its constituents were estimated for preconception and pregnancy windows using geocoded residential addresses.The associations of single and mixed exposures with LGA risk were analyzed using generalized linear models(GLMs)and qg-computation. [Results]Exposures to PM2.5 and its major chemical constituents were significantly associated with an increased LGA risk,with differences in effect magnitude across components.Secondary inorganic aerosols showed the strongest associations.For full-pregnancy exposure,nitrate(OR=1.330,95%CI:1.313,1.347),ammonium(OR=1.279,95%CI:1.263,1.295),and sulfate(OR=1.242,95%CI:1.227,1.257)had larger effects on LGA risk than black carbon and organic matter.Analysis by exposure window indicated that the month preceding con-ception and the third trimester of pregnancy were critical exposure windows for susceptibility,while the strongest effect was observed for full-pregnancy exposure,suggesting a cumulative effect over time.Mixed exposure analysis further showed that nitrate and sulfate consistently accounted for the main positive contributions across different time windows. [Conclusion]Maternal exposures to PM2.5 and its chemical components before and during pregnancy are associated with an elevated LGA risk.Nitrate and sulfate show consistent and strong associations across pregnancy stages,underscoring the importance of component composition and exposure timing in fetal overgrowth.
邬迪;彭勃;刘星言;张亚;任周鹏;王媛媛;马旭
国家卫生健康委科学技术研究所,北京 100081||国家人类遗传资源中心,北京 102206||北京协和医学院,北京 100730国家卫生健康委科学技术研究所,北京 100081||国家人类遗传资源中心,北京 102206||北京协和医学院,北京 100730国家卫生健康委科学技术研究所,北京 100081||国家人类遗传资源中心,北京 102206||北京协和医学院,北京 100730国家卫生健康委科学技术研究所,北京 100081||国家人类遗传资源中心,北京 102206中国科学院地理科学与资源研究所,地理信息科学与技术全国重点实验室,北京 100101国家卫生健康委科学技术研究所,北京 100081||国家人类遗传资源中心,北京 102206||北京协和医学院,北京 100730国家卫生健康委科学技术研究所,北京 100081||国家人类遗传资源中心,北京 102206||北京协和医学院,北京 100730
医药卫生
细颗粒物化学组分硝酸盐硫酸盐大于胎龄儿
fine particulate matterchemical componentnitratesulfatelarge for gestational age
《环境与职业医学》 2026 (6)
676-683,8
国家重点研发计划项目(2016YFC1000301) This study was funded.
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