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Adverse birth outcomes in Victoria, Australia in association with maternal exposure to low levels of ambient air pollution.
Environmental Research ( IF 8.3 ) Pub Date : 2020-06-13 , DOI: 10.1016/j.envres.2020.109784
Shannon Melody 1 , Karen Wills 1 , Luke D Knibbs 2 , Jane Ford 3 , Alison Venn 1 , Fay Johnston 1
Affiliation  

Background

The relationship between maternal exposure to air pollution and birth outcomes is not well characterised where ambient air pollution is relatively low.

Objectives

We aimed to explore the association between maternal exposure to ambient nitrogen dioxide (NO2) and fine particulate matter (PM2.5) and a range of birth outcomes in Victoria, Australia. Secondary aims were to explore whether obstetric conditions, such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy, were effect modifiers in observed relationships.

Methods

We included all singleton births occurring in Victoria, Australia from 1st March 2012 to 31st December 2015 using routinely collected government data. Outcomes included birth weight, small for gestational age (SGA), term low birth weight (tLBW), large for gestational age (LGA), and spontaneous preterm birth (sPTB). We estimated exposure to annual ambient NO2 and PM2.5 concentrations, assigned to maternal residence at time of birth. Confounders included maternal, meteorological and temporal variables. Multivariable linear regression and log-binomial regression were used for continuous and dichotomous outcomes, respectively.

Results

There were 285,594 births during the study period. Average NO2 exposure was 6.0 parts per billion (ppb, median 5.6; interquartile range (IQR) 3.9) and PM2.5 was 6.9 μg/m3 (median 7.1, IQR 1.3). IQR increases in ambient NO2 and PM2.5 were associated with fetal growth restriction, including decrements in birth weight (NO2 β −22.8 g; 95%CI -26.0, −19.7; PM2.5 β −14.8 g; 95%CI -17.4, −12.2) and increased risk of SGA (NO2 RR 1.08; 95%CI 1.06, 1.10; PM2.5 RR 1.05; 95%CI 1.04, 1.07) and tLBW (NO2 RR 1.06; 95%CI 1.01, 1.10; PM2.5 RR 1.04; 95%CI 1.03, 1.08). Women with GDM and hypertensive disorders of pregnancy had greater decrements in birth weight in association with pollutant exposure.

Discussion

In this exploratory study using an annual metric of exposure, maternal exposure to low-level ambient air pollution was associated with fetal growth restriction, which carries substantial public health implications.



中文翻译:

澳大利亚维多利亚州的不良分娩结局与孕产妇暴露于低水平的空气污染有关。

背景

在周围空气污染相对较低的情况下,孕产妇暴露于空气污染与出生结局之间的关系并没有得到很好的描述。

目标

我们旨在探讨澳大利亚维多利亚州孕产妇暴露于环境二氧化氮(NO 2)和细颗粒物(PM 2.5)与一系列出生结局之间的关系。第二个目的是探讨诸如妊娠糖尿病(GDM)和妊娠高血压疾病等产科疾病是否是观察到的关系的影响因素。

方法

我们使用常规收集的政府数据,包括了2012年3月1至2015年12月31在澳大利亚维多利亚州发生的所有单胎出生。结果包括出生体重,小胎龄(SGA),足月低出生体重(tLBW),大胎龄(LGA)和自发早产(sPTB)。我们估算了在出生时分配给母亲居住的年度环境NO 2和PM 2.5浓度的暴露。混杂因素包括孕产妇,气象和时间变量。多变量线性回归和对数二项回归分别用于连续和二分结果。

结果

在研究期间,有285,594例出生。NO 2的平均暴露量为十亿分之6.0(ppb,中位数5.6;四分位间距(IQR)3.9),PM 2.5为6.9μg/ m 3(中位数7.1,IQR 1.3)。在环境NO IQR增大2和PM 2.5用胎儿生长受限关联的,包括在出生体重减量(NO 2 β-22.8克; 95%CI -26.0,-19.7; PM 2.5 β-14.8克; 95%CI -17.4 ,-12.2)和SGA(NO 2 RR 1.08; 95%CI 1.06,1.10 ; PM 2.5 RR 1.05; 95%CI 1.04,1.07)和tLBW(NO 2 RR 1.06; 95%CI 1.01,1.10 ; PM )的风险增加2.5相对湿度1.04; 95%CI 1.03,1.08)。患有GDM和妊娠高血压疾病的妇女,随着污染物的暴露,出生体重的下降幅度更大。

讨论区

在这项使用年度暴露量度标准的探索性研究中,母亲暴露于低水平的环境空气污染与胎儿生长受限有关,这对公共健康产生了重大影响。

更新日期:2020-06-23
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