在妊娠期暴露于室外空气污染和儿童哮喘、过敏性鼻炎、湿疹
2016/08/31
摘要
背景：越来越多的证据表明，暴露于环境空气污染与儿童过敏性疾病的发展有关，但产前暴露于空气污染对儿童哮喘和过敏的风险的影响目前还不清楚。
目的：在2598名3-6岁中国学龄前儿童中，我们评估母体在不同的妊娠阶段暴露于室外空气污染与哮喘、过敏性鼻炎和湿疹发病率之间的关联。
方法：采用问卷调查法来获得儿童过敏性疾病的发病率。个体孕期暴露在室外的空气污染通过测量空气检测站的污染物浓度利用反距离加权法（IDW）来评估。我们采用多元回归方法来估计哮喘、过敏性鼻炎、湿疹的每四分位数间距（IQR）每个妊娠周期空气污染物增加的比值比（OR），并用多污染物/妊娠孕期模型将其校正其他空气污染物的影响和在其他妊娠期的影响。
结果：儿童哮喘（6.8%）、过敏性鼻炎（7.3%）、和湿疹（28.6%）的发病率与母亲整个怀孕期间的暴露于交通相关的污染物NO2相关，OR（95%可信区间[CI]）分别为1.63（0.99-2.70），1.69（1.03-2.77），和1.37（1.04-1.80）。校正之后，对其他污染物和孕期，我们发现这种相关性只在特定孕期存在：湿疹在孕早期（1.54，1.14-2.09哮喘），哮喘在孕中期（1.72，1.02-2.97），过敏性鼻炎在孕晚期（1.77，1.09-2.89）。敏感性分析表明，孕期对过敏性疾病发展的敏感性是稳定的。
结论：孕妇怀孕期间暴露于交通相关的NO2空气污染物，尤其是在特定的孕期，与儿童患哮喘、鼻炎和湿疹的风险增加相关。我们的研究结果支持这一假设：儿童过敏性疾病起源于胚胎，可在敏感的孕期由交通相关空气污染引发。
（杨冬 审校）
Environ Res. 2016 Jun 6;150:119-127. doi: 10.1016/j.envres.2016.05.050. [Epub ahead of print]
Exposure to outdoor air pollution during trimesters of pregnancy and childhood asthma, allergic rhinitis, and eczema.
Deng Q1, Lu C2, Li Y3, Sundell J4, Dan Norbäck5.
Author information
Abstract
BACKGROUND:Mounting evidence suggests that exposure to ambient air pollution is associated with the development of childhood allergic diseases, but the effect of prenatal exposure to air pollution on the risk of childhood asthma and allergy is unclear.
OBJECTIVES:We evaluated the association between maternal exposure to outdoor air pollution during different trimesters of pregnancy and incidence of asthma, allergic rhinitis, and eczema in 2598 preschool children aged 3-6 years in China.
METHODS:Children's lifetime incidence of allergic diseases was obtained using questionnaire. Individual exposure to outdoor air pollutants during trimesters of pregnancy was estimated by an inverse distance weighted (IDW) method based on the measured concentrations at monitoring stations. We used multiple logistic regression method to estimate the odds ratio (OR) of asthma, allergic rhinitis, and eczema for per interquartile range (IQR) increase in the exposure to air pollutant in each trimester, which was adjusted for the effect of other air pollutants and its effect in other trimesters by a multi-pollutant/trimester model.
RESULTS:Incidence of asthma (6.8%), allergic rhinitis (7.3%), and eczema (28.6%) in children was associated with maternal exposure to traffic-related pollutant NO2 during entire pregnancy with OR (95% confidence interval [CI]) respectively 1.63 (0.99-2.70), 1.69 (1.03-2.77), and 1.37 (1.04-1.80). After adjustment for other pollutants and trimesters, we found the association was significant only in specific trimester: the first trimester for eczema (1.54, 1.14-2.09), the second trimester for asthma (1.72, 1.02-2.97), and the third trimester for allergic rhinitis (1.77, 1.09-2.89). Sensitivity analysis indicated that the trimester sensitive to the development of allergic diseases was stable.
CONCLUSION:Maternal exposure to traffic-related air pollutant NO2 during pregnancy, especially in specific trimesters, is associated with an increased risk of developing asthma, rhinitis, and eczema in children. Our results support the hypothesis that childhood allergic diseases originate in fetal life and are triggered by traffic-related air pollution in sensitive trimesters.
Copyright © 2016 Elsevier Inc. All rights reserved.
KEYWORDS:Allergy; Fetal origins; Multi- pollutant and trimester model; Prenatal exposure; Traffic-related air pollution
Environ Res. 2016 Jun 6;150:119-127. doi: 10.1016/j.envres.2016.05.050. [Epub ahead of print]
