Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (2): 120-125 DOI: 10.3969/j.issn.2095-5340.2022.02.007 |
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| Association between ambient PM2.5 exposure and the risk of preterm birth in Shanghai |
| He Liyun, Zhu Yixiang, Du Li, et al
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(1. Office of General Affair, Shanghai Center forWomen and Children’s Health, Shanghai 200062, China; 2. Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China)
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Abstract 【Abstract】 Objective To explore the effect of particle matter ≤2.5 μm (PM2.5) pollution level and exposure time on preterm birth in Shanghai. Method Using stratified random sampling method, 20
secondary and tertiary hospitals covering 11 administrative regions were selected from Shanghai. The pregnantwomen were randomly selected according to the hospitalization number who delivered from January 1, 2016to June 30, 2016. The exclusion criteria were: the age of the pregnant woman less than 20 years old, thegestational week of delivery less than 28 weeks, the congenital malformation of the newborn; the dataincomplete or obviously wrong. Eventually, 10 370 pregnant women were enrolled into our study. The pretermbirth group was divided into mild preterm birth (32-36+6 weeks) and early preterm birth (28-31+ 6 weeks) accordingto the gestational weeks. Daily PM2.5 in the same period was collected, then calculated the average exposurein the first trimester (1-12 weeks), the second trimester (13- 27 weeks), the third trimester (after 28 weeks)and the whole pregnancy (average exposure level = sum of daily exposure÷ days). Chi-square test, analysisof Variance, Spearman correlation analysis and Unconditional Logistic regression model were used in ourstudy. Result The average individual exposure concentration among all pregnant women of PM2.5 duringthe entire pregnancy was (53.5±3.6) μg/m3. The average exposure levels were (42.2±6.1), (56.7±11.9)and (59.8±9.4) μg/m3 in early, middle and late pregnancy respectively, exceeding the limit of national classⅡ standard (35.0 μg/m3). In the first trimester , the exposure level of PM2.5 was highest in early pretermbirth (28 -31+6 weeks) group[(55.1±15.2) μg/m3] and lowest in full-term group[(42.0±5.6) μg/m3]. Thefollowing covariates were included in the Logistic regression equation: maternal age, educational level,gender, number of births, parity, history of preterm delivery, history of abortion, stillbirth, delivery mode,pregnancy complications, and environmental temperature and relative humidity. The result showed that effectof each 10 μg/m3 increase of PM2.5 during the entire pregnancy was significant on preterm birth (OR=1.027;95%CI: 1.010-1.041), mild preterm birth (32-36+6 weeks) (OR=1.038; 95%CI: 1.013-1.045) and early pretermbirth (28-31+6 weeks) (OR=1.006; 95%CI: 1.001-1.010). In the first trimester, each 10 μg/m3 increase ofPM2.5 exposure was significantly associated with an increased risk of preterm birth (OR=1.040; 95%CI:1.019~1.044), mild preterm birth (32-36+6 weeks) (OR=1.046; 95%CI: 1.023-1.058) and early preterm birth(28-31+6 weeks) (OR=1.015; 95%CI: 1.012-1.019). There was no significant correlation between the increasedexposure level of PM2.5 and preterm birth in the second trimester and the third trimester. Conclusion Maternal exposure to PM2.5 increases the risk of preterm birth, and the risk is strongest for mild preterm births
(32-36+6 weeks), especially during the first trimester.
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Received: 24 February 2021
Published: 31 March 2022
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