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目的综合以往发表的相关文献,分析不同妊娠窗口期大气颗粒物(PM_(2.5)、PM_(10))暴露对早产的影响。方法检索国内外2000年1月1日—2015年10月1日公开发表的关于大气颗粒物暴露对早产影响的研究文献,根据纳入及排除标准筛选出符合要求的文献26篇,采用R 3.1.1软件的metafor统计包对入选文献进行异质性检验和相应的效应值合并,并对结果进行敏感性分析、发表偏倚检验和校正,评价妊娠窗口期颗粒物暴露对早产的影响。结果通过建立各妊娠窗口期大气颗粒物与早产的暴露-反应关系,发现大气PM_(2.5)浓度每升高10μg/m~3,妊娠早、中、晚期及整个妊娠期早产发生的合并OR(95%CI)分别为1.10(1.01~1.21),1.07(0.79~1.45),1.04(0.97~1.10),1.05(0.97~1.13);大气PM10浓度每升高10μg/m~3,妊娠早、中、晚期及整个妊娠期早产发生的合并OR(95%CI)分别为0.98(0.97~1.00),0.99(0.98~1.01),1.01(0.99~1.04)和1.00(1.00~1.00)。结论不同妊娠窗口期的大气颗粒物暴露所致早产发生风险存在差异,妊娠早期大气PM_(2.5)的暴露可明显增加早产风险。
OBJECTIVE: To analyze the effect of exposure to PM 2 (2.5) and PM 10 (10 PM 10) on preterm labor in different gestation windows based on previous published literatures. Methods The literatures published at home and abroad from January 1, 2000 to October 1, 2015 on the impact of exposure to atmospheric particulate matter on preterm birth were screened. Twenty-six qualified literatures were screened out based on the inclusion and exclusion criteria. R 3.1.1 Software metafor statistical package for selected documents heterogeneity test and the corresponding effect value of the merger, and the results of sensitivity analysis, publication bias test and correction, assessment of pregnancy window particulate matter exposure to preterm birth. Results By establishing the exposure-response relationship between atmospheric particulate matter and preterm birth at each window of pregnancy, it was found that the combined OR (95 % CI) were 1.10 (1.01-1.21), 1.07 (0.79-1.45), 1.04 (0.97-1.10) and 1.05 (0.97-1.13), respectively. For every 10μg / m ~ The pooled OR (95% CI) for late stage and preterm preterm pregnancy were 0.98 (0.97-1.00), 0.99 (0.98-1.01), 1.01 (0.99-1.04) and 1.00 (1.00-1.00), respectively. Conclusions There are differences in the risk of preterm birth due to exposure to atmospheric particulates at different gestational window stages. Exposure to PM 2.5 during early gestation may significantly increase the risk of premature delivery.