背景:虽然环境空气污染与单胎胎儿的生长有关,由于该领域的研究有限,其在双胞胎之间的相关性尚不明确。
方法:在上海市第九人民医院生殖医学中心(上海,中国)2007年至2021年。其他与出生体重相关的结果包括巨大儿,低出生体重,出生体重很低,小于胎龄(SGA)。使用线性混合效应模型和随机效应逻辑回归模型分析了PM2.5暴露与出生体重的关系。结合分布式滞后模型(DLM)来估计时变关联。
结果:研究结果表明,整个怀孕期间PM2.5暴露的四分位数间距(IQR)增加(18μg/m3)与显着增加有关(57.06g,双胞胎总出生体重的95%置信区间[CI]:30.91,83.22)。在较大的胎儿(34.93g,95%CI:21.13,48.72)与较小的胎儿(21.77g,95%CI:6.94,36.60)双胎妊娠。此外,整个怀孕期间PM2.5暴露的IQR增加与LGA风险增加34%相关(95%CI:11%,63%)。此外,PM2.5的特定化学成分,如硫酸盐(SO42-),表现出与PM2.5总质量相当的效果估计。
结论:总体而言,研究结果表明,暴露于PM2.5及其特定成分与双胞胎胎儿过度生长有关。
BACKGROUND: While ambient air pollution has been associated with fetal growth in singletons, its correlation among twins is not well-established due to limited research in this area.
METHODS: The effects of exposure to PM2.5 particulate matter and its main components during pregnancy on birth weight and the incidence of large for gestational age (LGA) were investigated in 6177 twins born after in vitro fertilization at the Center for Reproductive Medicine of Shanghai Ninth People\'s Hospital (Shanghai, China) between 2007 and 2021. Other birth weight-related outcomes included macrosomia, low birth weight, very low birth weight, and small for gestational age (SGA). The associations of PM2.5 exposure with birth weight outcomes were analyzed using linear mixed-effect models and random-effect logistic regression models. Distributed lag models were incorporated to estimate the time-varying associations.
RESULTS: The findings revealed that an interquartile range (IQR) increase (18 μg/m3) in PM2.5 exposure over the entire pregnancy was associated with a significant increase (57.06 g, 95 % confidence interval [CI]: 30.91, 83.22) in the total birth weight of twins. The effect was more pronounced in larger fetuses (34.93 g, 95 % CI: 21.13, 48.72) compared to smaller fetuses (21.77 g, 95 % CI: 6.94, 36.60) within
twin pregnancies. Additionally, an IQR increase in PM2.5 exposure over the entire pregnancy was associated with a 34 % increase in the risk of LGA (95 % CI: 11 %, 63 %). Furthermore, specific chemical components of PM2.5, such as sulfate (SO42-), exhibited effect estimates comparable to the PM2.5 total mass.
CONCLUSIONS: Overall, the findings indicate that exposures to PM2.5 and its specific components are associated with fetal overgrowth in twins.