Abstract:
This study aimed to determine the relationships between prenatal PM2.5 exposure and childhood growth trajectories during the first 6 years of life. A total of 47,625 pairs of mothers and children were recruited from a prospective birth cohort conducted between 2011 and 2013 in Wuhan, China, and followed for 6 years. We used the group-based trajectory models to classify the population into three trajectory groups: slow growth (n = 13,671, 28.7%), normal growth (n = 29,736, 62.4%), and rapid growth (n = 4218, 8.9%). Multinomial logistic regression models were used to determine the associations of prenatal PM2.5 exposure and childhood growth trajectories. Compared to normal growth trajectory, increased PM2.5 exposure in trimester 1, trimester 2 and the entire pregnancy showed significant associations with an increased risk of the slow growth trajectory but reduced the risk for the rapid growth trajectory, significant association of prenatal PM2.5 exposure with rapid growth trajectory was only observed in the trimester 3. Stratified analyses displayed relatively stronger associations among those mothers with maternal age over 35 years, pre-pregnancy BMI ≥ 25 kg/m2, and previous delivery experience. Prenatal exposure to PM2.5, particularly during the midpoint period of pregnancy, was more likely to have a slow growth trajectory and a lower risk of rapid growth trajectory. Maternal age, pre-pregnancy BMI, and previous delivery experience might modify these associations.
摘要:
这项研究旨在确定出生前6年的PM2.5暴露与儿童生长轨迹之间的关系。从2011年至2013年在武汉进行的前瞻性出生队列中,共招募了47,625对母亲和儿童。中国,并跟踪了6年。我们使用基于组的轨迹模型将人口分为三个轨迹组:缓慢增长(n=13,671,28.7%),正常生长(n=29,736,62.4%),快速增长(n=4218,8.9%)。使用多项逻辑回归模型来确定产前PM2.5暴露与儿童生长轨迹的关联。与正常的增长轨迹相比,在妊娠1、2和整个妊娠期间,PM2.5暴露增加与缓慢生长轨迹的风险增加显著相关,但降低了快速增长轨迹的风险,产前PM2.5暴露与快速生长轨迹的显著关联仅在3个月观察到.分层分析显示,母亲年龄超过35岁的母亲之间的关联相对更强,孕前BMI≥25kg/m2,既往分娩经验。产前暴露于PM2.5,特别是在怀孕的中点,更有可能具有缓慢的增长轨迹和较低的快速增长轨迹的风险。产妇年龄,孕前BMI,和以前的交付经验可能会修改这些关联。