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[背景]越来越多的证据显示,母亲空气污染暴露与对胎儿生长的不良影响之间存在关联;但是,现有的文献并不一致。[目的]研究9个国家14个中心的数据,量化母亲颗粒物空气污染暴露与足月出生体重和低出生体重(LBW)之间的关联,并探讨此关联中地点特征和暴露评估方法对中心之间异质性的影响。[方法]空气污染与妊娠结局国际合作(ICAPPO)的各中心采用共同的分析方案,对PM10和PM2.5(颗粒物≤10和2.5μm)与足月LBW和连续出生体重进行效应评估。采用meta分析将各个中心(~300万例出生)的效应评估结合起来,并采用meta回归分析在报告的效应评估中,中心特征和暴露评估方法对中心之间异质性的影响。[结果]随机效应meta分析显示,调整母亲的社会经济地位后,在整个妊娠期间,足月LBW与PM10[比值比(OR)=1.03;95%CI:1.01~1.05]和PM2.5[OR=1.10;95%CI:1.03~1.18]每增加10μg/m3呈正相关。在充分调整随机效应的meta分析中,作为一个连续性的结果,PM10暴露每增加10μg/m3与足月出生体重呈负相关(-8.9g;95%CI:-13.2~-4.6 g)。meta回归分析显示,具有较高平均PM2.5水平和PM2.5∶PM10比率的中心,以及采用时间暴露评估(与时空相比)的中心,所报告的关联更强。[结论]在研究人群中,母亲颗粒物污染暴露与足月LBW相关联。有3个地点特征和暴露评估方法学方面的不同导致各个中心报告的关联的差异。
[Background] There is growing evidence that there is a link between maternal exposure to air pollution and adverse effects on fetal growth; however, the existing literature is not consistent. [Objective] To study the data of 14 centers in 9 countries, to quantify the correlation between PMW exposure and full-term birth weight and low birth weight (LBW), and to explore the relationship between location characteristics and exposure assessment methods The impact of heterogeneity. [Method] Centers for International Cooperation in Air Pollution and Pregnancy Outcomes (ICAPPO) evaluated the effects of PM10 and PM2.5 (particulate matter ≤10 and 2.5 μm) with full-term LBW and continuous birth weight using a common analytical protocol. Meta-analysis was used to combine the effects assessments for each center (~ 3 million births) and the meta-regression was used to analyze the impact of central characteristics and exposure assessment methods on the heterogeneity of centers in the reported effects assessment. [Results] Random-effects meta-analysis showed that after adjusting for mother’s socioeconomic status, full-term LBW to PM10 [odds ratio (OR) = 1.03; 95% CI: 1.01 to 1.05] and PM2.5 [OR = 1.10; 95% CI: 1.03 ~ 1.18] was positively correlated with each additional 10μg / m3. In a meta-analysis that adequately adjusted for random effects, each 10 μg / m3 increase in PM10 exposure was negatively correlated with term birth weight as a continuum (-8.9 g; 95% CI: -13.2 -4.6 g). Meta-regression analysis showed that centers with higher average PM2.5 levels and PM2.5: PM10 ratios, and centers reported using time exposure assessment (compared to space-time) reported stronger associations. [Conclusions] In the study population, maternal PM contamination exposure was associated with full-term LBW. Differences in the methodology of the three site characteristics and exposure assessment led to differences in reporting between centers.