大气细颗粒物和高温天气对不良出生结局影响的暴露-反应关系及其交互作用研究

Associations between ambient fine particulate matter (PM2.5), high temperature and adverse birth outcomes such as preterm birth, low birth weight and birth defects have been reported. Our previous studies found that PM10 exposure in the last trimester were positively associated with the occurrence of preterm birth, and the consecutive exposure of ambient high temperature during pregnancy could increase the risks of preterm birth and stillbirth. Studies on the issue of how to evaluate the potential interactions between PM2.5 and ambient high temperature are rare. In this study, the birth records, air pollution data and meteorological data during 2013-2015 in 3 regions with different air pollution levels in Beijing will be collected, extended Cox proportional hazard regression models with time-dependent covariates will be performed to assess the effects of PM2.5 and ambient high temperature on preterm birth, low birth weight and birth defects after adjustment of confounding factors; in addition, the interactions and the effect modifications of PM2.5 and ambient high temperature will be evaluated by using Cox regression models with interaction and additive hazards models. This study will provide some methodological support, and may also shed a new light on preventing the birth-related hazards of PM2.5 and ambient high temperature exposure.

大气细颗粒物（PM2.5）和高温天气与不良出生结局如早产、低出生体重和出生缺陷的发生有关。本课题组前期研究发现孕后期可吸入颗粒物（PM10）的暴露与早产的发生呈正相关，持续高温天气可增加胎儿早产和死胎死产的风险。然而关于PM2.5和高温天气交互作用对不良出生结局的影响国内外尚未见报道。本项目拟通过收集北京市具有不同污染水平和特征的3个代表性区县2013-2015年的出生登记资料，结合相应的大气污染和气象监测资料，采用含有时间依存性变量的Cox回归分析模型，在调整混杂因素基础上评价我国现有的大气污染高浓度暴露水平下, 大气PM2.5和高温天气对早产、低出生体重以及出生缺陷发生率影响的暴露-反应关系特征；并采用含有交互项的 Cox回归模型和可加危险度模型等统计分析方法探讨大气PM2.5和高温天气的交互作用。该研究可为科学预防和降低大气PM2.5和高温天气对孕产妇和胎儿的健康危害提供理论依据。

大气细颗粒物（PM2.5）和极端天气与不良出生结局如早产和低出生体重的发生有关。然而关于PM2.5和高温天气交互作用对不良出生结局的影响国内外尚未见报道。本项目通过收集北京市不同区县2013-2015年的出生记录资料，结合相应的大气污染和气象监测资料，采用含有时间依存性变量的Cox回归分析模型，在调整混杂因素基础上评价我国现有的大气污染高浓度暴露水平下, 大气PM2.5和高温天气对早产、低出生体重发生率影响的暴露-反应关系特征；并采用含有交互项的 Cox回归模型和可加危险度模型等统计分析方法探讨大气PM2.5和高温天气的交互作用。本研究结果显示：大气PM2.5对孕妇早产发生的影响具有统计学意义。 PM2.5浓度每升高10 μg/m3，造成早产发生的危险度上升(HR：1.0043，95%CI: 1.0002-1.0084)；极端低温与孕妇早产的发生有关，气温每降低1℃，将导致早产发生的危险度增加(HR:1.3163 95%CI: 1.1713-1.4792); 大气PM2.5和极端气温对早产的发生存在交互作用(p<0.05)。该研究可为科学预防和降低大气PM2.5和高温天气对孕产妇和胎儿的健康危害提供理论依据。