Background

Air pollution is associated with mental health in the general population, but its influence on maternal mental health during pregnancy has not been assessed.

Objective

We evaluated the relationship between unspecified mental disorders complicating pregnancy and depression with average air pollution exposure during 3-months preconception, first trimester and whole pregnancy.

Methods

Ambient air pollution was derived from a modified Community Multiscale Air Quality model and mental health diagnoses were based on electronic intrapartum medical records. Logistic regression models assessed the odds of unspecified mental disorder complicating pregnancy (n = 11,577) and depression (n = 9793) associated with an interquartile range increase in particulate matter (PM) less than 2.5 μm (PM_2.5), PM₁₀, carbon monoxide (CO), nitrogen dioxide (NO₂), nitrogen oxide (NO_x), sulfur dioxide (SO₂), and ozone (O₃). Pregnancies without mental health disorders were the reference group (n = 211,645). Models were adjusted for maternal characteristics and study site; analyses were repeated using cases with no additional mental health co-morbidity.

Results

Whole pregnancy exposure to PM₁₀, PM_2.5, NO₂, and NO_x was associated with a 29%–74% increased odds of unspecified mental disorders complicating pregnancy while CO was associated with 31% decreased odds. Results were similar for depression: whole pregnancy exposure to PM₁₀, PM_2.5, NO₂, and NO_x was associated with 11%–21% increased odds and CO and O₃ were associated with 16%–20% decreased odds. SO₂ results were inconsistent, with increased odds for unspecified mental disorders complicating pregnancy and decreased odds for depression. While most findings were similar or stronger among cases with no co-morbidity, PM_2.5 and NO_x were associated with reduced risk and SO₂ with increased risk for depression only.

Discussion

Whole pregnancy exposure to PM₁₀, PM_2.5, NO₂, and NO_x were associated with unspecified mental disorder complicating pregnancy and depression, but some results varied for depression only. These risks merit further investigation.

中文翻译：

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长期暴露于空气污染和妊娠合并精神健康障碍的风险

背景

空气污染与一般人群的心理健康有关，但尚未评估其对孕期产妇心理健康的影响。

客观的

我们评估了妊娠前 3 个月、妊娠早期和整个妊娠期间未明确的妊娠合并精神障碍和抑郁症与平均空气污染暴露之间的关系。

方法

环境空气污染来自修改后的社区多尺度空气质量模型，心理健康诊断基于电子产时医疗记录。_{逻辑回归模型评估了与小于 2.5 μm (PM 2.5} )、PM ₁₀、一氧化碳的颗粒物 (PM) 四分位间距增加相关的妊娠合并症 (n = 11,577) 和抑郁症 (n = 9793) 的几率(CO)、二氧化氮(NO ₂ )、氮氧化物(NO _x )、二氧化硫(SO ₂ )和臭氧(O ₃）。没有精神健康障碍的怀孕是参考组（n = 211,645）。模型根据母体特征和研究地点进行了调整；使用没有其他心理健康合并症的病例重复分析。

结果

整个孕期暴露于 PM ₁₀、PM _2.5、NO ₂和 NO _x与妊娠合并未明确精神障碍的几率增加 29%–74% 相关，而 CO 与降低 31% 的几率相关。抑郁症的结果相似：整个孕期暴露于 PM ₁₀、PM _2.5、NO ₂和 NO _x的几率增加 11%–21%，而 CO 和 O ₃的几率降低 16%–20%。二氧化硫_{_}结果不一致，妊娠合并未指明精神障碍的几率增加，而抑郁症的几率降低。虽然大多数发现在没有合并症的病例中相似或更强，但 PM _2.5和 NO _x与风险降低相关，而 SO ₂仅与抑郁风险增加相关。

讨论

整个孕期暴露于 PM ₁₀、PM _2.5、NO ₂和 NO _x与妊娠期和抑郁症的未明确精神障碍相关，但一些结果仅因抑郁症而异。这些风险值得进一步调查。