Independent and Combined Effects of Late-Pregnancy Exposure to Air Pollution and Extreme Temperature on Preterm Birth in China: A Nationwide Cohort Study

中国 怀孕 医学 环境卫生 队列研究 空气污染 环境科学 队列 早产 产科 人口学 地理 妊娠期 生物 内科学 社会学 考古 遗传学 生态学
作者
Xiang Xiao,Ruixia Liu,Yunjiang Yu,Zheng Zhang,Luke D. Knibbs,Bin Jalaludin,Lidia Morawska,Shyamali C. Dharmage,Joachim Heinrich,Stefania Papatheodorou,Yuming Guo,Yangyang Xu,Ling Jin,Guo Guo,Wentao Yue,Jilong Yao,Yue Zhang,Chengrong Wang,Shen Gao,Enjie Zhang,Shaofei Su,Tong Zhu,Guang‐Hui Dong,Meng Gao,Chenghong Yin
出处
期刊:Social Science Research Network [Social Science Electronic Publishing]
被引量:2
标识
DOI:10.2139/ssrn.4082921
摘要

Background: Independent and joint effects of perinatal exposure to air pollution and heat stress on preterm birth (PTB) remain less explored. Methods: We obtained 103,040 birth records from September 2018 to December 2020. Gestational age was recorded in days, and PTB was defined as gestational age < 37 completed weeks. Hourly air pollution (PM2·5, NO2, and O3) and temperature data were obtained from the national monitoring stations and ERA5 land reanalysis dataset, respectively. Generalized additive models with restricted cubic splines were performed to evaluate the independent and joint associations, as well as the shape of exposure-response curve between trimester-specific exposure and gestational age and PTB, adjusting for covariates. Findings: Nonlinear associations with threshold effects between air pollutants, temperature and preterm birth were observed. The adjusted risk ratios for PTB of PM2·5, O3, NO2, and temperature at the 95 th percentile against thresholds were 1·32 (95% CI: 1·23, 1·42), 1·28 (95% CI: 1·19, 1·39), 1·44 (95% CI: 1·33, 1·56) and 1·70 (95% CI: 1·56, 1·85), respectively. Positive additive interactions [relative excess risk due to interaction, RERI > 0] of PM2.5 –High Temperature (HT), O3 –HT, O3 –Low Temperature (LT) are identified, but the interactive effects of PM 2·5 and LT were negative (RERI < 0). Interpretation: Maternal exposures to PM2.5, O3, and both low and high temperature were independently associated with increased risk of preterm birth. Air pollutants and high temperature extremes showed additive interaction effects. Given the potential interactive effects, health measures for pregnant women should consider both air pollution and temperature.Funding Information: This study was supported by the National Key Research and Development Program of China (2016YFC1000101, 2018YFE0106900), National Natural Science Foundation of China (81872582, 81872583, M-0420), Guangdong Provincial Natural Science Foundation Team Project (2018B030312005), Natural Science Foundation of Guangdong Province (2021A1515011754, 2021B1515020015, 2020A1515011131), and Research Grants Council of the Hong Kong Special Administrative Region, China (HKBU22201820).Declaration of Interests: None declared.Ethics Approval Statement: The study protocol was approved by the ethics committee of the Sun Yat-sen University.

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