Study On The Associations Between Prenatal Exposure To Air Pollutants And Birth Outcomes Or Growth Devel Pment In Some Regions Of Jiangsu

Air pollution is a major environmental problem in the world,which has widespread and harmful influence on human health.The global disease burden study of 2010 pointed out that as many as 3.1 million deaths worldwide were caused by air pollution.Among all the air pollutants,particulate matter(PM),caused the most serious adverse effects on health.In recent years,many studies have showed that air pollutions harmed cardiovascular and respiratory system obviously.Meanwhile,the number of research focusing on the health effects of air pollution on offspring keeps increasing.however,the consistent conclusion is still absent yet.Fetal stage is the earliest stage of life development,and the harmful stimulation of pollutant during this period will directly affect the later birth outcome and neurobehavioral development level.Preterm birth and low birth weight have been reported as the major causes of neonatal mortality in China in recent years.The nervous system plays an important role in transmitting signals between parts of the body and receiving feedback,and the dysplasia of nervous system is associated with autism and even Alzheimer’s disease in the elderly.Nowadays,many researches have focused on the associations between air pollution and low birth weight,preterm birth,as well as neurobehavioral development worldwide,particularly in Europe and the United States.However,the consistent result was not reached In addition,the domestic researches in this area,especially the researches related to the development of neurobehavioral development,are still rare.Jiangsu province,located in the Yangtze River Delta Coast,is densely populated and well-developed both in economy and industrial.Thereafter,pollution problem is more serious.Therefore,to investigate the level of air pollutants in this area and their health effects is of great significance.Based on the hospital sources,and retrospective cohort studies in Jiangsu,we try to find out the effects of air pollutants on offspring birth outcomes and their development and the key time window of exposure.Thus,we can find prevention strategies for reducing adverse pregnancy outcomes and neurological retardation,which has important significance to public health.[Objective]Through the combination of monitoring data from monitoring sites with space model and hospital sources,epidemiological methods were used to study the associations between the exposure of atmospheric pollutants and neonatal birth weight as well as neural development of offspring in Jiangsu.[Method]1.1080 pregnant women who took production inspection and delivery in Nanjing Maternity and Child Health Hospital from 2008-2014 were enrolled in.We calculated the starting time of pregnancy and divided it into three trimesters according to the last menstrual period.With combining the PM2.5 monitoring data of 9 national monitoring sites in Nanjing during this time,exposure concentrations of three trimesters were estimated using IDW.Then we recorded the birth information and followed up that the international common Gesell developmental scales was used to evaluate mental development at the time points of 6 months,12 months,and 24 months for each child.The generalized estimating equation was used to analyze the association between PM2.5 exposure during pregnancy and offspring neurodevelopment.2.A total of 26,998 delivery data in Taizhou Maternal and Child Health Care Center from 2013-2016 and PM2.5 concentrations from the monitoring sites for each gravida were obtained.The inverse distance weighted method(IDW)was used to estimate the PM2.5 and NO2 exposure concentrations of gravidas during each trimester and the whole pregnancy.Logistic regression analysis was carried out to explore the correlation between exposure to air pollutants and preterm birth and low birth weight.[Results]1.High concentration of PM2.5 exposure during pregnancy reduces gross motor development quotient of the offspring at 6 months old,and will also reduce the fine motor quotient of 12-month old children.Statistical study found that using the GEE model,exposure to high concentration of PM2.5 during the early and middle trimester was associated with a reduction in the adaptive developmental quotient of offspring younger than 2 years old.2.The adjusted multiple logistic regression model showed that after controlling the effects of common factors and other two kinds of pollutants,exposure to high concentrations of NO2 during the second trimester increased the risk of premature birth and low birth weight[adjusted relative risk(aRR)for an interquartile range increase:aRR=1.59,95%CI:1.44～1.75;aRR=1.12,95%CI:1.02～1.23].High concentration of PM2.5 exposure during the second trimester may increase the risk of premature birth[aRR=1.30,95%CI:1.21～1.38].[Conclusion]PM2.5 exposure in the gestation period is associated with neurodevelopmental dysplasia in offspring;PM2.5,and NO2 exposure in the second trimester is a risk factor for preterm birth,and NO2 is also a risk factor for term low birth weight;Primary prevention is the most effective preventive measure to control and reduce adverse pregnancy outcomes.