Joint effects of prenatal exposure to air pollution and pregnancy-related anxiety on birth weight: A prospective birth cohort study in Ma' anshan, China

Authors：Zhen-Hua Li , Yi-Cheng Mao , Yang Li, Sun Zhang , Hui-Yu Hu , Zhe-Ye Liu , Xue-Jie Liu , Jia-Wen Zhao , Kai Huang , Mao-Lin Chen , Guo-Peng Gao , Cheng-Yang Hu , Xiu-Jun Zhang

Source：Environ Res. 2023 Sep 15:117161.

DOI: 10.1016/j.envres.2023.117161

 

Abstract：

Background:A growing number of studies have shown that prenatal exposure to chemical and non-chemical stressors has effects on fetal growth. The co-exposure of both better reflects real-life exposure patterns. However, no studies have included air pollutants and pregnancy-related anxiety (PrA) as mixtures in the analysis.

Method:Using the birth cohort study method, 576 mother-child pairs were included in the Ma'anshan Maternal and Child Health Hospital. Evaluate the exposure levels of six air pollutants during pregnancy using inverse distance weighting (IDW) based on the pregnant woman's residential address and air pollution data from monitoring stations. Prenatal anxiety levels were assessed using the PrA Questionnaire. Generalized linear regression (GLR), quantile g-computation (QgC) and bayesian kernel machine regression (BKMR) were used to assess the independent or combined effects of air pollutants and PrA on birth weight for gestational age z-score (BWz).

Result:The results of GLR indicate that the correlation between the six air pollutants and PrA with BWz varies depending on the different stages of pregnancy and pollutants. The QgC shows that during trimester 1, when air pollutants and PrA are considered as a whole exposure, an increase of one quartile is significantly negatively correlated with BWz. The BKMR similarly indicates that during trimester 1, the combined exposure of air pollutants and PrA is moderately correlated with a decrease in BWz.

Conclusion:Using the method of analyzing mixed exposures, we found that during pregnancy, the combined exposure of air pollutants and PrA, particularly during trimester 1, is associated with BWz decrease. This supports the view that prenatal exposure to chemical and non-chemical stressors has an impact on fetal growth.

Keywords: Air pollution; Birth weight; Mixture; Pregnancy-related anxiety.

 

摘要：

背景：越来越多的研究表明，产前暴露于化学和非化学应激源对胎儿生长有影响。两者的共同曝光更好地反映了现实生活中的曝光模式。然而，没有研究将空气污染物和妊娠相关焦虑（PrA）作为分析中的混合物。

方法：采用出生队列研究方法，马鞍山市妇幼保健院纳入576对母子。根据孕妇的居住地址和监测站的空气污染数据，使用反距离加权（IDW）评估怀孕期间六种空气污染物的暴露水平。使用PrA问卷评估产前焦虑水平。采用广义线性回归（GLR）、分位数g计算（QgC）和贝叶斯核机回归（BKMR）评估空气污染物和PrA对胎龄z评分（BWz）出生体重的独立或综合影响。

结果：GLR的结果表明，六种空气污染物与PrA与BWz的相关性因怀孕和污染物的不同而有所不同。QgC表明，在孕期1期间，当空气污染物和PrA被视为整体暴露时，增加一个四分位数与BWz显着负相关。BKMR同样表明，在孕早期间，空气污染物和PrA的综合暴露与BWz的降低呈中度相关。

结论：使用分析混合暴露的方法，我们发现在怀孕期间，空气污染物和PrA的组合暴露，特别是在孕早期期间，与BWz降低有关。这支持了产前暴露于化学和非化学应激源对胎儿生长有影响的观点。

关键词：空气污染；出生体重；混合物；怀孕相关焦虑