Ambient air pollution and low birthweight: a European cohort study (ESCAPE)

被引：426

作者：

Pedersen, Marie ^{[1
,2
,3
]}

Giorgis-Allemand, Lise ^{[3
,4
]}

Bernard, Claire ^{[3
,4
]}

Aguilera, Inmaculada ^{[1
,2
]}

Andersen, Anne-Marie Nybo ^{[5
]}

Ballester, Ferran ^{[2
,6
,7
,8
]}

Beelen, Rob M. J. ^{[9
]}

Chatzi, Leda ^{[10
]}

Cirach, Marta ^{[1
]}

Danileviciute, Asta ^{[12
]}

Dedele, Audrius ^{[12
]}

van Eijsden, Manon ^{[13
]}

Estarlich, Marisa ^{[2
,8
]}

Fernandez-Somoano, Ana ^{[2
,14
]}

Fernandez, Mariana F. ^{[2
,15
]}

Forastiere, Francesco ^{[16
]}

Gehring, Ulrike ^{[9
]}

Grazuleviciene, Regina ^{[12
]}

Gruzieva, Olena ^{[17
]}

Heude, Barbara ^{[18
,19
]}

Hoek, Gerard ^{[9
]}

de Hoogh, Kees ^{[20
]}

van den Hooven, Edith H. ^{[21
,22
]}

Haberg, Siri E. ^{[23
]}

Jaddoe, Vincent W. V. ^{[21
,22
]}

Kluemper, Claudia ^{[24
]}

Korek, Michal ^{[17
]}

Kraemer, Ursula ^{[24
]}

Lerchundi, Aitana ^{[25
]}

Lepeule, Johanna ^{[3
,4
,26
]}

Nafstad, Per ^{[23
,27
]}

Nystad, Wenche ^{[23
]}

Patelarou, Evridiki ^{[10
,28
]}

Porta, Daniela ^{[16
]}

Postma, Dirkje ^{[29
]}

Raaschou-Nielsen, Ole ^{[30
]}

Rudnai, Peter ^{[31
]}

Sunyer, Jordi ^{[1
,2
,32
]}

Stephanou, Euripides ^{[11
]}

Sorensen, Mette ^{[30
]}

Thiering, Elisabeth ^{[33
]}

Tuffnell, Derek ^{[34
]}

Varro, Mihaly J. ^{[31
]}

Vrijkotte, Tanja G. M. ^{[35
]}

Wijga, Alet ^{[36
]}

Wilhelm, Michael ^{[37
]}

Wright, John ^{[34
]}

Nieuwenhuijsen, Mark J. ^{[1
,2
]}

Pershagen, Goeran ^{[17
,38
]}

Brunekreef, Bert ^{[9
,39
]}

机构：

[1] Ctr Res Environm Epidemiol, 88 Doctor Aiguader Rd, Barcelona 08003, Spain

[2] Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain

[3] INSERM, U823, Team Environm Epidemiol Appl Reprod & Resp Hlth, Inst Albert Bonniot, Grenoble, France

[4] Univ Grenoble 1, Inst Albert Bonniot, Grenoble, France

[5] Univ Copenhagen, Dept Social Med, Copenhagen, Denmark

[6] Ctr Publ Hlth Res, Valencia, Spain

[7] Univ Valencia, Valencia, Spain

[8] Fdn Invest Sanitaria & Biomed, Ctr Publ Hlth Res, Valencia, Spain

[9] Univ Utrecht, Inst Risk Assessment Sci, Utrecht, Netherlands

[10] Univ Crete, Dept Social Med, Fac Med, Iraklion, Greece

[11] Univ Crete, Environm Chem Proc Lab, Dept Chem, Iraklion, Greece

[12] Vytauto Didziojo Univ, Dept Environm Sci, Kaunas, Lithuania

[13] Publ Hlth Serv, Dept Epidemiol Documentat & Hlth Promot, Amsterdam, Netherlands

[14] Univ Oviedo, Oviedo, Spain

[15] San Cecilio Univ Hosp, Biomed Res Ctr Granada, Lab Med Invest, Granada, Spain

[16] Lazio Reg Hlth Serv, Dept Epidemiol, Rome, Italy

[17] Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden

[18] INSERM, UMR 1018, Team 10, Ctr Res Epidemiol & Populat Hlth, Villejuif, France

[19] Univ Paris 11, UMRS 1018, Villejuif, France

[20] Univ London Imperial Coll Sci Technol & Med, Res Council Hlth Protect Agcy Ctr Environm & Hlth, London, England

[21] Erasmus MC, Generat Study Grp R, Dept Epidemiol, Rotterdam, Netherlands

[22] Erasmus MC, Dept Paediat, Rotterdam, Netherlands

[23] Natl Inst Publ Hlth, Div Epidemiol, Oslo, Norway

[24] Univ Dusseldorf, Inst Umweltmed Forsch, Dusseldorf, Germany

[25] Univ Basque Country, Dept Publ Hlth & Prevent Med, Bilbao, Spain

[26] Harvard Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA

[27] Univ Oslo, Dept Community Med, Fac Med, Oslo, Norway

[28] Kings Coll London, Florence Nightingale Sch Nursing & Midwifery, London WC2R 2LS, England

[29] Univ Groningen, Univ Med Ctr Groningen, Dept Pulmonol, Groningen, Netherlands

[30] Danish Canc Soc, Res Ctr, Copenhagen, Denmark

[31] Natl Inst Environm Hlth, Budapest, Hungary

[32] Pompeu Fabra Univ, Barcelona, Spain

[33] Helmholtz Ctr Munich, Inst Epidemiol 1, Neuherberg, Germany

[34] Bradford Teaching Hosp NHS Trust, Bradford Inst Hlth Res, Bradford, W Yorkshire, England

[35] Univ Amsterdam, Acad Med Ctr, Dept Publ Hlth, NL-1105 AZ Amsterdam, Netherlands

[36] Natl Inst Publ Hlth & Environm, Ctr Nutr Prevent & Hlth Serv, NL-3720 BA Bilthoven, Netherlands

[37] Ruhr Univ Bochum, Dept Hyg Social & Environm Med, Bochum, Germany

[38] Stockholm Cty Council, Dept Occupat & Environm Hlth, Stockholm, Sweden

[39] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[40] Hosp del Mar Med Res Inst IMIM, Barcelona, Spain

[41] Natl Sch Publ Hlth, Athens, Greece

来源：

LANCET RESPIRATORY MEDICINE | 2013年 / 1卷 / 09期

关键词：

USE REGRESSION-MODELS; RESIDENTIAL-MOBILITY; PRENATAL EXPOSURE; TERM; PREGNANCY; GROWTH; FETAL; RISK; LIFE; CHILDHOOD;

D O I：

10.1016/S2213-2600(13)70192-9

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background Ambient air pollution has been associated with restricted fetal growth, which is linked with adverse respiratory health in childhood. We assessed the effect of maternal exposure to low concentrations of ambient air pollution on birthweight. Methods We pooled data from 14 population-based mother-child cohort studies in 12 European countries. Overall, the study population included 74 178 women who had singleton deliveries between Feb 11, 1994, and June 2, 2011, and for whom information about infant birthweight, gestational age, and sex was available. The primary outcome of interest was low birthweight at term (weight <2500 g at birth after 37 weeks of gestation). Mean concentrations of particulate matter with an aerodynamic diameter of less than 2.5 mu m (PM2.5), less than 10 mu m (PM10), and between 2.5 mu m and 10 mu m during pregnancy were estimated at maternal home addresses with temporally adjusted land-use regression models, as was PM2.5 absorbance and concentrations of nitrogen dioxide (NO 2) and nitrogen oxides. We also investigated traffic density on the nearest road and total traffic load. We calculated pooled effect estimates with random-effects models. Findings A 5 mu g/m(3) increase in concentration of PM2.5 during pregnancy was associated with an increased risk of low birthweight at term (adjusted odds ratio [OR] 1.18, 95% CI 1.06-1.33). An increased risk was also recorded for pregnancy concentrations lower than the present European Union annual PM2.5 limit of 25 mu g/m(3) (OR for 5 mu g/m(3) increase in participants exposed to concentrations of less than 20 mu g/m(3) 1.41, 95% CI 1.20-1.65). PM10 (OR for 10 mu g/m(3) increase 1.16, 95% CI 1.00-1.35), NO2 (OR for 10 mu g/m(3) increase 1.09, 1.00-1.19), and traffic density on nearest street (OR for increase of 5000 vehicles per day 1.06, 1.01-1.11) were also associated with increased risk of low birthweight at term. The population attributable risk estimated for a reduction in PM2.5 concentration to 10 mu g/m(3) during pregnancy corresponded to a decrease of 22% (95% CI 8-33%) in cases of low birthweight at term. Interpretation Exposure to ambient air pollutants and traffic during pregnancy is associated with restricted fetal growth. A substantial proportion of cases of low birthweight at term could be prevented in Europe if urban air pollution was reduced.

引用

页码：695 / 704

页数：10

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