| Summary: | 碩士 === 中國醫藥大學 === 職業安全與衛生學系碩士班 === 100 === Epidemiological studies have reported that preterm births or low birth weight may increase the risk of infant mortality, but this risk has no consistent evidences in the different gestational period for the effects of air pollution exposure. The objective of this study was to evaluate associations between the adverse pregnancy and ambient air pollution exposure level at different trimesters of gestational.
We conducted a matched-pairs case-control study in Taiwan. The source population was the birth registration data from 2001 to 2007. The cases and controls were one to three matched by year of conception and gestational age. Final, the study population was comprised of 83,649 cases and 250,947 controls. Exposure to air pollutants were obtained from the monitoring data provided by the Environment Protection Agency, and the exposure to each subject was estimated by a geographic information system using inverse distance weighting method. The air pollutant measurements from the 3 closets monitoring stations within 25 km of each residence were integrated to the weekly average concentration. We used conditional logistic regression models to estimate the odds ratios of air pollution on preterm births in each trimester. Further, we performed stratified analysis to investigate the effect modification between air pollution and maternal health on preterm births.
In one-pollutant model, women exposure to 8hr-O3 and PM10 increased the risk of preterm births in the first and second trimester. Preterm births were increased in association with a 10 ppb increase in second trimester 8hr-O3 level (adjusted OR=1.016, 95% CI: 1.002, 1.029). Preterm births were also associated with a 10 μg/m3 increase in PM10 during the second (adjusted OR=1.029, 95% CI: 1.021, 1.037) trimester of gestation. We found the effect modification between 8hr-O3, PM10 and diabetes on preterm births in each trimester (p for interaction <0.05).
The study provides evidence that exposure to outdoor air 8hr-O3 and PM10 may increase the risk of preterm births and that the most susceptible time periods for exposure are during the second trimester of gestation, especially for maternal diabetes.
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