Evaluating the Impact of Maternal Exposure to Ozone on Twin Fetal Growth in China

四分位间距 怀孕 出生体重 医学 置信区间 产科 胎儿 低出生体重 逻辑回归 双胎妊娠 人口学 生物 内科学 遗传学 社会学
作者
Yang Shen,Hongping Zhang,Shenpeng Wu,Jing Dong,Huimin Li,Ying Yang,Jihong Xu,Ya Zhang,Qiaomei Wang,Haiping Shen,Yiping Zhang,Donghai Yan,Lifang Jiang,Xueyi Xu,Guangbin Quan,Xia Meng,Yuan He,Jing Cai,Haidong Kan,Xu Ma
出处
期刊:Environmental Science & Technology [American Chemical Society]
卷期号:57 (49): 20470-20479 被引量:2
标识
DOI:10.1021/acs.est.3c04999
摘要

Unlike singletons, twins require attention not only to the birth weight of the fetuses but also to discordance (i.e., the differences between weights) because twin growth discordance is a significant factor contributing to perinatal mortality and morbidity in twin pregnancies. However, the impact of maternal air pollution exposure on twin growth discordance has rarely been investigated. We examined the association of long-term ozone exposure during preconception and pregnancy with the birth weight of twins and twin growth discordance among 35,795 twins from the National Free Preconception Health Examination Project between January 2010 and December 2019. Linear mixed-effect models and random-effect logistic regression models were used to examine the associations of ozone exposure with the birth weight-related outcomes (i.e., birth weight of twins and within-pair birth weight difference) and risk of twin growth discordance, respectively, after adjustment for demographic characteristics and lifestyle. We found that an interquartile range (IQR) increase (15 μg/m3) in ozone exposure during the entire pregnancy was associated with a reduction (−28.96g, 95% confidence interval [CI]: −46.37, −11.56) in the total birth weight of twins, and ozone had a more pronounced impact on the birth weight of the smaller fetuses (−18.28 g, 95% CI: −27.22, −9.34) compared to the larger fetuses (−9.88 g, 95% CI: −18.84, −0.92) in twin pregnancies. An IQR increase in ozone exposure during the entire pregnancy was associated with a significant increase (8.41 g, 95% CI: 4.13, 12.69) in the within-pair birth weight difference; the odds ratio (OR) of twin growth discordance related to ozone exposure increased by 9% (OR = 1.09, 95% CI: 1.01, 1.18). However, no consistently significant associations were observed for ozone exposure during prepregnancy. Male–male twin pairs and those who were born prematurely appeared to be more susceptible to ozone exposure than their counterparts. Long-term ozone exposure during pregnancy was associated with twin growth discordance, and our findings provide reference data for future studies.
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