Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China.
Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, 101101, China.
Environ Res. 2023 Feb 1;218:115023. doi: 10.1016/j.envres.2022.115023. Epub 2022 Dec 8.
The effects of fine particulate matter (PM) on de novo hypertensive disorders of pregnancy (HDP) were inconsistent during the first and second trimesters. This study aimed to assess the trimester-specific effects of PM and PM prior to diagnosis of de novo HDP. The exposure of fine PM was predicted by satellite remote sensing data according to maternal residential addresses. De novo HDP was defined as gestational hypertension and preeclampsia during the current pregnancy. A logistic regression model was performed to assess the association of PM and PM with HDP during the first and early second trimesters (0-13 weeks and 14-20 weeks). The generalized estimating equation model was conducted to assess the effect of PM and PM on blood pressure. The present study included 22,821 pregnant women (mean age, 29.1 years) from 2013 to 2017. PM and PM were significantly associated with an increased risk of de novo HDP during the first trimester (OR = 1.070, 95% CI: 1.013-1.130; OR = 1.264, 95% CI: 1.058-1.511 for per 10 μg/m) and early second trimester (OR = 1.045, 95% CI: 1.003-1.088; OR = 1.170, 95% CI: 1.002-1.366 for per 10 μg/m). Significant trends of increased de novo HDP risk was also observed with the increment of PM (all P for trend <0.05). The stratified analyses demonstrated that the associations between exposure to fine PM and the risk of HDP were more pronounced among the pregnant women with maternal age above 35 and low maternal education level (all OR >1.047). Each 10 μg/m increase of PM and PM before diagnosis of de novo HDP elevated 0.204 (95% CI: 0.098-0.310) and 0.058 (95%CI: 0.033-0.083) mmHg of systolic blood pressure. Exposure to PM and PM during the first and early second trimester were positively associated with the risk of de novo HDP. The fine PM before diagnosis of de novo HDP elevated the systolic blood pressure.
颗粒物(PM)对妊娠期间新发高血压疾病(HDP)的影响在第一和第二孕期不一致。本研究旨在评估 PM 和 PM 在诊断新发 HDP 之前的孕期特异性影响。通过卫星遥感数据根据母亲的居住地址预测细颗粒物的暴露情况。新发 HDP 定义为当前妊娠期间的妊娠高血压和子痫前期。采用逻辑回归模型评估 PM 和 PM 与第一和早期第二孕期(0-13 周和 14-20 周)HDP 的相关性。采用广义估计方程模型评估 PM 和 PM 对血压的影响。本研究纳入了 2013 年至 2017 年期间的 22821 名孕妇(平均年龄 29.1 岁)。PM 和 PM 与第一孕期(OR=1.070,95%CI:1.013-1.130;OR=1.264,95%CI:1.058-1.511,每增加 10μg/m)和早期第二孕期(OR=1.045,95%CI:1.003-1.088;OR=1.170,95%CI:1.002-1.366,每增加 10μg/m)新发 HDP 的风险显著增加。随着 PM 的增加,新发 HDP 风险也呈显著增加趋势(所有趋势 P<0.05)。分层分析表明,在母亲年龄大于 35 岁和母亲教育水平较低的孕妇中,细颗粒物暴露与 HDP 风险之间的关系更为显著(所有 OR>1.047)。在诊断为新发 HDP 之前,PM 和 PM 每增加 10μg/m,收缩压分别升高 0.204(95%CI:0.098-0.310)和 0.058(95%CI:0.033-0.083)mmHg。第一和早期第二孕期 PM 和 PM 的暴露与新发 HDP 的风险呈正相关。诊断为新发 HDP 之前的细颗粒物 PM 升高了收缩压。