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請使用永久網址來引用或連結此文件:
http://ir.cmu.edu.tw/ir/handle/310903500/46221
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| 題名: | 空氣污染及產婦健康狀況對新生兒早產之相關研究
The effects of air pollution and maternal health on preterm births |
| 作者: | 林育廷;Lin, Yu-Ting |
| 貢獻者: | 職業安全與衛生學系碩士班 |
| 關鍵詞: | 空氣污染物;早產;糖尿病;交互作用;air pollution;preterm births;diabetes;effect modification |
| 日期: | 2012-07-23 |
| 上傳時間: | 2012-08-31 16:36:02 (UTC+8) |
| 出版者: | 中國醫藥大學 |
| 摘要: | 許多流行病學研究指出早產會增加新生兒出生的死亡率，而暴露在環境空氣汙染可能會增加產婦早產的發生，然而不同的空氣汙染物在不同懷孕週期的暴露，對產婦所造成的生殖危害卻無一致性的結果。本研究的目的為針對產婦暴露於不同妊娠週期的空氣污染物進行新生兒早產之相關探討。
本研究採用配對病例對照研究設計，研究族群為2001-2007年台灣出生通報登記檔之胎兒，病例組與對照組的選取以受孕的年份及胎齡為條件，進行1：3的配對，最後病例組共有83,649位及250,947位對照組。在空氣污染物暴露部份，則使用環保署空氣品質監測站公布的空氣汙染物資料，結合地理資訊系統使用反距離權重法，採25公里內最靠近的三個監測站為基礎，進行個案暴露量的推估。本研究採用條件式邏輯斯迴歸進行產婦於不同妊娠週期暴露於空氣汙染物對早產影響之分析，並利用分層分析法探討特殊產婦健康狀況與暴露於空氣污染物對早產是否有交互作用存在。
本研究共納入334,596名個案，分析結果發現，在第一及二妊娠週期暴露每增加10 ppb的8hr-O3及10 ug/m3的PM10對早產均有危險性的提高，且在第二妊娠週期其調整後的暴露勝算比及百分之九十五信賴區間分別為1.016 (95% CI=1.002-1.029)及1.029 (95% CI=1.021-1.037)，均達統計學上顯著差異。本研究發現產婦在不同妊娠週期暴露8hr-O3或PM10與糖尿病對早產有交互作用存在，並進一步進行分層分析，發現罹患糖尿病之產婦暴露8hr-O3或PM10之不良影響明顯大於未罹患糖尿病之產婦。
本研究結果顯示，產婦在第二妊娠週期暴露於8hr-O3及PM10均會增加早產的危險性，且罹患糖尿病之產婦為暴露空氣污染物較易造成新生兒早產之易感受族群。
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. |
| 顯示於類別: | [職業安全與衛生學系暨碩士班] 博碩士論文
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