Objective

Exposure to airborne pollutants during pregnancy appears to be associated with uterine growth restriction and adverse neonatal outcome. Proprotein convertase subtilisin/kexin type (PCSK9), the key modulator of low-density lipoprotein (LDL) metabolism, increases following particulate matter (PM₁₀) exposure. Because maternal cholesterol is required for fetal growth, PCSK9 levels could be used to evaluate the potential impact of airborne pollutants on fetal growth.

Design

A cohort of 134 healthy women during early pregnancy (11–12 weeks of gestational age) was studied.

Results

A significant association between circulating PCSK9 levels and three tested air pollutants (PM₁₀, PM_2.5, nitric oxide (NO₂)) was found. Of importance, gestational age at birth was reduced by approximately 1 week for each 100 ng/mL rise in circulating PCSK9 levels, an effect that became more significant at the highest quartile of PM_2.5 (with a 1.8 week advance in delivery date for every 100 ng/mL rise in circulating PCSK9; p for interaction = 0.026). This finding was supported by an elevation of the odds ratio for urgent cesarean delivery for each 100 ng/mL rise in PCSK9 (2.99, 95% CI, 1.22–6.57), similar trends being obtained for PM₁₀ and NO₂.

Conclusions

The association between exposure to air pollutants during pregnancy and elevation in PCSK9 advances our understanding of the unforeseen influences of environmental exposure in terms of pregnancy associated disorders.

中文翻译：

---

孕产妇暴露于空气污染物、PCSK9 水平、胎儿生长和胎龄——意大利队列

客观的

怀孕期间暴露于空气污染物似乎与子宫生长受限和新生儿不良结局有关。前蛋白转化酶枯草杆菌蛋白酶/kexin 型 (PCSK9) 是低密度脂蛋白 (LDL) 代谢的关键调节剂，在接触颗粒物 (PM ₁₀ ) 后会增加。由于胎儿生长需要母体胆固醇，PCSK9 水平可用于评估空气污染物对胎儿生长的潜在影响。

设计

对妊娠早期（11-12 周胎龄）的 134 名健康女性进行了研究。

结果

发现循环 PCSK9 水平与三种测试的空气污染物（PM ₁₀、PM _2.5、一氧化氮（NO ₂））之间存在显着关联。重要的是，循环 PCSK9 水平每升高 100 ng/mL，出生胎龄减少约 1 周，这一影响在 PM _2.5的最高四分位数时变得更加显着（每 100 人的分娩日期提前 1.8 周） ng/mL 循环 PCSK9 升高；p 交互作用 = 0.026）。这一发现得到了 PCSK9 每升高 100 ng/mL 的紧急剖宫产比值比升高的支持（2.99，95% CI，1.22-6.57），PM ₁₀和 NO ₂也获得了类似的趋势。

结论

怀孕期间暴露于空气污染物与 PCSK9 升高之间的关联促进了我们对环境暴露对妊娠相关疾病的不可预见影响的理解。