邯郸市妇女空气污染暴露对妊娠期高血压的影响

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (956 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要选择河北省邯郸市某医院孕妇数据, 探讨了6项空气污染物暴露对孕妇患妊娠期高血压(GH)的影响和不同人群的效应差异, 采用传统Logistic回归模型评估了各项污染物的效应, 采用主成分改进的Logistic回归模型评估了各项污染物在额外调整其它污染物后的效应.结果显示, 单污染物模型中, 妊娠期前26周每20μg/m³增量的O₃暴露与患病风险呈显著正相关关系(OR=1.211, 95%CI: 1.094~1.340), 且在妊娠前期的效应大于在妊娠中期的效应.多污染物模型中, 孕前3个月每20μg/m³增量的PM_2.5和PM₁₀暴露显著增加了患病的风险, OR值分别为1.021(95%CI: 1.004~1.038)和1.016(95%CI: 1.002~1.031);妊娠期前26周每20μg/m³增量的O₃暴露也对患病风险有显著效应(OR=1.026, 95%CI: 1.002~1.050).亚组分析结果显示, 25~30岁或初次妊娠的孕妇孕前3个月对PM_2.5、PM₁₀、NO₂和CO的暴露较为敏感, >35岁或学历为大学以下的孕妇妊娠期前26周受O₃暴露的影响更易患病.总的来说, 邯郸市空气污染对孕妇患GH存在显著的影响, 孕妇应在孕前和妊娠期间做好防护, 降低空气污染暴露造成的不利影响.

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	曹蕾
	王婷
	王丽君
	刁瑞萍
	于丽敬
	崔小丽
	毛洪钧

关键词 ：妊娠期高血压, 空气污染, 怀孕, 队列研究

Abstract：The traditional logistic regression model was used to evaluate the effects of exposure to various pollutants on GH, and the logistic regression model based on principal component analysis was used to evaluate the effects on GH by additionally adjusting parameters of other pollutants. Results of single-pollutant model showed that each 20μg/m³ increment of O₃ was significantly positively correlated with the increased risk of GH (OR=1.211, 95%CI: 1.094~1.340) during the first 26 weeks of gestation, and the effect in the first trimester was greater than that in the second trimester. In multi-pollutant model, each 20μg/m³ increment of PM_2.5 and PM₁₀ exposure significantly increased the GH risk of pregnant women in the three months before pregnancy, with OR values of 1.021 (95%CI: 1.004~1.038) for PM_2.5 and 1.016 (95%CI: 1.002~1.031) for PM₁₀. Consistent with the results of single-pollutant model, each 20μg/m³ increment of O₃ exposure also had a significant effect on the risk of GH (OR=1.026, 95%CI: 1.002~1.050) during the first 26 weeks of gestation in multi-pollutant model. The results of subgroup analysis showed that pregnant women aged 25~30 years or those in the first pregnancy were susceptible to PM_2.5, PM₁₀, NO₂ and CO exposure before pregnancy, while pregnant women over 35 years old or without college degrees were more likely to develop GH due to O₃ exposure during pregnancy. In summary, air pollution in Handan has significant impacts on pregnant women inducing suffering from GH. To mitigate the negative impacts of exposure to air pollution, more attention should be paid to the enhancement of air pollution protection awareness for pregnant women before and during pregnancy.

Key words： gestational hypertension air pollution pregnancy cohort study

收稿日期: 2021-06-05

PACS:

X703.5

基金资助:中央高校基本科研业务费(63211075)

通讯作者: 毛洪钧, 教授, hongjun_mao@hotmail.com E-mail: hongjun_mao@hotmail.com

作者简介: 曹蕾(1997-), 女, 山西长治人, 南开大学硕士研究生, 主要从事大气污染与人体健康研究

引用本文:

曹蕾, 王婷, 王丽君, 刁瑞萍, 于丽敬, 崔小丽, 毛洪钧. 邯郸市妇女空气污染暴露对妊娠期高血压的影响[J]. 中国环境科学, 2022, 42(1): 444-455. CAO Lei, WANG Ting, WANG Li-jun, DIAO Rui-ping, YU Li-jing, CUI Xiao-li, MAO Hong-jun. Maternal exposure to ambient air pollution and gestational hypertension in Handan. CHINA ENVIRONMENTAL SCIENCECE, 2022, 42(1): 444-455.

链接本文:

http://www.zghjkx.com.cn/CN/ 或 http://www.zghjkx.com.cn/CN/Y2022/V42/I1/444

[1]	Fan S J, Heinrich J, Bloom M S, et al. Ambient air pollution and depression: A systematic review with meta-analysis up to 2019 [J]. Science of the Total Environment, 2020, 701: 134721.
[2]	Nardone A, Neophytou A M, Balmes J, et al. Ambient air pollution and asthma-related outcomes in children of color of the USA: A scoping review of literature published between 2013 and 2017 [J]. Current Allergy and Asthma Reports, 2018, 18(5): 29.
[3]	Rajagopalan S, Al-Kindi S G, Brook R D. Air pollution and cardiovascular disease JACC state-of-the-art review[J]. Journal of the American College of Cardiology, 2018, 72(17): 2054-2070.
[4]	Murray C J L, Aravkin A Y, Zheng P, et al. Global burden of 87 risk factors in 204 countries and territories, 1990~2019: A systematic analysis for the global burden of disease study 2019 [J]. The Lancet, 2020, 396(10258): 1223-1249.
[5]	Jacobs M, Zhang G C, Chen S, et al. The association between ambient air pollution and selected adverse pregnancy outcomes in China: A systematic review [J]. Science of the Total Environment, 2017, 579: 1179-1192.
[6]	Madsen C, Haberg S E, Aamodt G, et al. Preeclampsia and hypertension during pregnancy in areas with relatively low levels of traffic air pollution [J]. Maternal and Child Health Journal, 2018, 22(4): 512-519.
[7]	Pedersen M, Halldorsson T I, Olsen S F, et al. Impact of road traffic pollution on pre-eclampsia and pregnancy-induced hypertensive disorders [J]. Epidemiology, 2017, 28(1): 99-106.
[8]	Zhu Y, Zhang C, Liu D, et al. Ambient air pollution and risk of gestational hypertension [J]. American Journal of Epidemiology, 2017, 186(3): 334-343.
[9]	Savitz D A, Elston B, Bobb J F, et al. Ambient fine particulate matter, nitrogen dioxide, and hypertensive disorders of pregnancy in New York City [J]. Epidemiology, 2015, 26(5): 748-757.
[10]	Lee P C, Roberts J M, Catov J M, et al. First trimester exposure to ambient air pollution, pregnancy complications and adverse birth outcomes in Allegheny County, PA [J]. Maternal and Child Health Journal, 2013, 17(3): 545-555.
[11]	Choe S A, Kauderer S, Eliot M N, et al. Air pollution, land use, and complications of pregnancy [J]. Science of the Total Environment, 2018, 645: 1057-1064.
[12]	Mendola P, Wallace M, Liu D, et al. Air pollution exposure and preeclampsia among US women with and without asthma [J]. Environmental Research, 2016, 148: 248-255.
[13]	Jo H, Eckel S P, Chen J C, et al. Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort [J]. Environment International, 2019, 130: 104933.
[14]	Wang Q, Zhang H, Liang Q, et al. Effects of prenatal exposure to air pollution on preeclampsia in Shenzhen, China [J]. Environmental Pollution, 2018, 237: 18-27.
[15]	杨明翰. 大气细颗粒物暴露与孕妇妊娠期血压变化的关联[D]. 武汉: 华中科技大学, 2019. Yang M H. Association between atmospheric fine particle exposure and blood pressure changes in pregnant women during pregnancy [D]. Wuhan: Huazhong University of Science and Technology, 2019.
[16]	赵伯毅. 呼和浩特市空气污染与妊娠疾病及不良出生结局关系研究[D]. 呼和浩特: 内蒙古大学, 2020. Zhao B Y. The association between air pollution exposure and pregnancy diseases and adverse birth outcomes in Hohhot [D]. Hohhot: Inner Mongolia University, 2020.
[17]	Huang X, Qiu J, Zhang Y, et al. Ambient air pollutant PM10 and risk of pregnancy-induced hypertension in urban China [J]. Environmental Research Letters, 2015, 10(8): 084025.
[18]	许亚宣, 李小敏, 于华通, 等. 邯郸市大气复合污染特征的监测研究[J]. 环境科学学报, 2015, 35(9): 2710-2722. Xu Y X, Li X M, Yu H T, et al. Characteristics of air pollution complex in Handan [J]. Acta Scientiae Circumstantiae, 2015, 35(9): 2710-2722.
[19]	李福燕, 李许明, 付冲, 等. 邯郸市区空气污染现状及其防治措施[J]. 环境卫生学杂志, 2015, 5(4): 357-360. Li F Y, Li X M, Fu C, et al. Air pollution and prevention measures in Handan [J]. Journal of Environmental Hygiene, 2015, 5(4): 357-360.
[20]	彭玏, 赵媛媛, 赵吉麟, 等. 京津冀大气污染传输通道区大气污染时空格局研究[J]. 中国环境科学, 2019, 39(2): 449-458. Peng L, Zhao Y Y, Zhao J L, et al. Spatiotemporal patterns of air pollution in air pollution transmission channel of Beijing-Tianjin-Hebei from 2000 to 2015 [J]. China Environmental Science, 2019, 39(2): 449-458.
[21]	伯鑫, 徐峻, 杜晓惠, 等. 京津冀地区钢铁企业大气污染影响评估[J]. 中国环境科学, 2017, 37(5): 1684-1692. Bo X, Xu J, Du X H, et al. Impacts assessment of steel plants on air quality over Beijing-Tianjin-Hebei area [J]. China Environmental Science, 2017, 37(5): 1684-1692.
[22]	邯郸市人民政府. 邯郸市综合概况[EB/OL]. http://www.hd.gov.cn/zjhd/hdgk/zhgk/202103/t20210324_1435054.html, 2021-04-27. Handan Municipal People's Government. Comprehensive overview of Handan City [EB/OL]. http://www.hd.gov.cn/zjhd/hdgk/zhgk/202103/t20210324_1435054.html, 2021-04-27.
[23]	Xu X, Hu H, Ha S, et al. Ambient air pollution and hypertensive disorder of pregnancy [J]. Journal of Epidemiology and Community Health, 2014, 68(1): 13-20.
[24]	行岳真, 祁瑞, 李金梅, 等. 主成分Logistic回归在筛选冠心病危险因素中的应用[J]. 实用预防医学, 2012, 19(8): 1138-1140. Xing Y Z, Qi R, Li J M, et al. Application of logistic regression based on principal component analysis in the screening of risk factors of coronary heart disease [J]. Practical Preventive Medicine, 2012, 19(8): 1138-1140.
[25]	裘炯良, 郑剑宁, 张扬. 主成分改进的Logistic回归模型方法在流行病学分析中的应用[J]. 中国热带医学, 2005, 5(2): 207-209. Qiu J L, Zheng J N, Zhang Y. Application of modified logistic regression model in the analysis of epidemiology [J]. China Tropical Medicine, 2005, 5(2): 207-209.
[26]	王丹, 潘晓平. 主成分logistic回归在筛选妊娠期糖尿病危险因素中的应用[J]. 现代预防医学, 2008, 35(5): 826-827, 830. Wang D, Pan X P. Application of logistic regression based on principal component analysis on risk factors of women with gestational diabetes mellitus[J]. Modern Preventive Medicine, 2008, 35(5): 826-827, 830.
[27]	GB 3095-2012环境空气质量标准[S]. GB 3095-2012 Ambient air quality standards [S].
[28]	顾颖, 冯亚玲, 许倩. 妊娠期高血压疾病的相关危险因素分析[J]. 中国卫生统计, 2017, 34(4): 618-619, 624. Gu Y, Feng Y L, Xu Q. Risk factors of hypertension in pregnancy [J]. Chinese Journal of Health Statistics, 2017, 34(4): 618-619, 624.
[29]	林彤, 陈丽红, 胡继芬, 等. 妊娠期高血压的危险因素[J]. 中华高血压杂志, 2015, 23(1): 83-85. Lin T, Chen L H, Hu J F, et al. Risk factors for hypertension during pregnancy[J]. Chinese Journal of Hypertension, 2015, 23(1): 83-85.
[30]	张秀兰, 袁碧波, 李增彦. 妊娠期高血压疾病发生的危险因素及预防措施分析[J]. 中国妇幼保健, 2017, 32(17): 4052-4054. Zhang X L, Yuan B B, Li Z Y. Analysis of risk factors and preventive measures of hypertensive diseases during pregnancy [J]. Maternal and Child Health Care of China, 2017, 32(17): 4052-4054.
[31]	Nobles C J, Williams A, Ouidir M, et al. Differential effect of ambient air pollution exposure on risk of gestational hypertension and preeclampsia [J]. Hypertension, 2019, 74(2): 384-390.
[32]	van den Hooven E H, de Kluizenaar Y, Pierik F H, et al. Air pollution, blood pressure, and the risk of hypertensive complications during pregnancy: The generation R study [J]. Hypertension, 2011, 57(3): 406-412.
[33]	Mobasher Z, Salam M T, Goodwin T M, et al. Associations between ambient air pollution and Hypertensive Disorders of Pregnancy [J]. Environmental Research, 2013, 123: 9-16.
[34]	Hu H, Ha S, Xu X. Ozone and hypertensive disorders of pregnancy in Florida: Identifying critical windows of exposure [J]. Environmental Research, 2017, 153: 120-125.
[35]	Rudra C B, Williams M A, Sheppard L, et al. Ambient carbon monoxide and fine particulate matter in relation to preeclampsia and preterm delivery in western Washington State [J]. Environmental Health Perspectives, 2011, 119(6): 886-892.
[36]	Najafi M L, Zarei M, Gohari A, et al. Preconception air pollution exposure and glucose tolerance in healthy pregnant women in a middle-income country [J]. Environmental Health, 2020, 19(1): 131.
[37]	Robledo C A, Mendola P, Yeung E, et al. Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus [J]. Environmental Research, 2015, 137: 316-322.
[38]	Michikawa T, Morokuma S, Fukushima K, et al. A register-based study of the association between air pollutants and hypertensive disorders in pregnancy among the Japanese population [J]. Environmental Research, 2015, 142: 644-650.
[39]	Choe S A, Eliot M N, Savitz D A, et al. Ambient air pollution during pregnancy and risk of gestational diabetes in New York City [J]. Environmental Research, 2019, 175: 414-420.
[40]	Pan S C, Huang C C, Lin S J, et al. Gestational diabetes mellitus was related to ambient air pollutant nitric oxide during early gestation [J]. Environmental Research, 2017, 158: 318-323.
[41]	张莹, 邵毅, 王式功, 等. 北京市空气污染物对呼吸系统疾病门诊人数的影响[J]. 中国环境科学, 2014, 34(9): 2401-2407. Zhang Y, Shao Y, Wang S G, et al. Relationship between air pollutant and respiratory diseases hospital outpatient visits in Beijing [J]. China Environmental Science, 2014, 34(9): 2401-2407.
[42]	刘情, 王笑笑, 张英奎, 等. 河北省2016年妇女妊娠期高血压疾病与年龄的相关性分析[J]. 中华流行病学杂志, 2018, 39(9): 1270-1273. Liu Q, Wang X X, Zhang Y K, et al. Correlation analysis of hypertensive disease during pregnancy and age in Hebei Province in 2016 [J]. Chinese Journal of Epidemiology, 2018, 39(9): 1270-1273.
[43]	王伟业. 武汉市孕妇孕期NO2暴露与胎儿生长及妊娠期糖尿病关系研究[D]. 武汉: 华中科技大学, 2017. Wang W Y. Gestational diabetes mellitus and fetal growth in association with maternal NO2 exposure during pregnancy in Wuhan city [D]. Wuhan: Huazhong University of Science and Technology, 2017.
[44]	Shiozaki A, Matsuda Y, Satoh S, et al. Comparison of risk factors for gestational hypertension and preeclampsia in Japanese singleton pregnancies [J]. Journal of Obstetrics and Gynaecology Research, 2013, 39(2): 492-499.
[45]	Li X, Tan H Z, Huang X, et al. Similarities and differences between the risk factors for gestational hypertension and preeclampsia: A population based cohort study in south China[J]. Pregnancy Hypertension-an International Journal of Womens Cardiovascular Health, 2016, 6(1): 66-71.
[46]	Lao T T, Hui A S Y, Law L W, et al. Prior abortion history and pregnancy hypertensive disorders in primiparous gravidae [J]. Pregnancy Hypertens, 2018, 14: 168-173.
[47]	张晓彤. 武汉市孕妇孕期空气细颗粒物暴露与早产的关联性研究[D]. 武汉: 武汉大学, 2020. Zhang X T. The association between maternal PM2.5 exposure and preterm birth in Wuhan [D]. Wuhan: Wuhan University, 2020.
[48]	Ng C, Malig B, Hasheminassab S, et al. Source apportionment of fine particulate matter and risk of term low birth weight in California: Exploring modification by region and maternal characteristics [J]. Science of the Total Environment, 2017, 605-606: 647-654.
[49]	董洁, 李梦茹, 孙若丹, 等. 我国空气质量标准执行现状及与国外标准比较研究[J]. 环境与可持续发展, 2015, 40(5): 87-92. Dong J, Li M R, Sun R D, et al. Study on the air quality standards of china and comparative with foreign standards [J]. Environment and Sustainable Development, 2015, 40(5): 87-92.
[50]	郭超, 郜志. 关于国内外臭氧限值浓度标准的探究[J]. 建筑科学, 2020, 36(2): 163-170, 199. Guo C, Gao Z. Research on ozone limit concentration standards at home and abroad [J]. Building Science, 2020, 36(2): 163-170, 199.
[51]	王宗爽, 武婷, 车飞, 等. 中外环境空气质量标准比较[J]. 环境科学研究, 2010, 23(3): 253-260. Wang Z S, Wu T, Che F, et al. Comparison between domestic and international ambient air quality standards [J]. Research of Environmental Sciences, 2010, 23(3): 253-260.