重庆市主城区孕妇居住地交通暴露和妊娠结局的关系研究

Association between traffic exposure and various adverse pregnancy outcomes in Chongqing urban areas

摘要:

目的：探讨孕妇居住地离主干道距离与不良妊娠结局的关系。方法：本研究为前瞻性队列研究，采用问卷调查的方式收集2015年9月至2016年8月在重庆医科大学附属第一医院首次产检的孕早期孕妇703人的相关信息，根据孕妇居住地与主干道距离将孕妇分为2组，距离≥250 m组共618人，距离<250 m组共85人，随访孕妇妊娠结局，纳入多因素分析，采用lo－gistic回归分析孕妇居住地离主干道距离与早产、妊娠期糖尿病、子痫前期、胎膜早盘、低出生体重儿、巨大儿的关系，多重线性回归分析孕妇居住地离主干道距离与新生儿体质量、身长的关系。结果：以孕妇住址离主干道距离≥250 m为对照，在调整了孕妇基本人口学特征后，孕妇住址离主干道距离<250 m不是早产（OR=0.669，95%CI=0.153～2.972，P=0.593）、妊娠期糖尿病（OR=0.784，95%CI=0.454～1.353，P=0.382）、子痫前期（OR=1.650，95%CI=0.454～5.991，P=0.447）、胎膜早破（OR=1.120，95%CI=0.672～1.867，P=0.664）、 低体重儿（OR=1.626，95%CI=0.455～5.809，P=0.454）及巨大儿（OR=1.932，95%CI=0.763～4.890，P=0.165）的危险因素，也不影响新生儿的体质量（OR=0.037，95%CI=-49.746～146.518，P=0.333）和身长（OR=0.009，95%CI=-0.350～0.445，P=0.813）。结论：孕妇家庭住址与主干道距离<250 m不是不良妊娠结局的危险因素。

Abstract:

Objective：To investigate the association between distance of pregnant women’s living place to main road and various ad－verse pregnancy outcomes. Methods：This is a prospective cohort study in Chongqing. A questionnaire survey was conducted to collect information of 703 pregnant women who received the first prenatal examination in the First Affiliated Hospital of Chongqing Medical University from September 2015 to August 2016. The pregnant women were divided into two groups according to the distance between the residence and the main road：a total of 618 pregnant women lived ≥250 meters from the main road and a total of 85 pregnant women lived <250 meters. The pregnancy outcomes of two groups were followed up and were enrolled in multivariate analysis. The logistic regression was used to analyze the relationship between residential proximity to main road and premature birth，gesta－tional diabetes mellitus，preeclampsia，premature rupture of mem－branes，low birth weight and macrosomia，respectively. Multiple linear regression was used to explore the association among residential proximity to main road and neonatal weight and body length. Results：Taking the pregnant woman’s residence at a distance of ≥250 meters from the main road as control，after adjusting the basic demographic characteristics of pregnant women，the distance <250 meters was not a risk factor for preterm birth（OR=0.669，95%CI=0.153-2.972，P=0.593），gestational diabetes mellitus（OR=0.784，95%CI=0.454-1.353，P=0.382），preeclampsia（OR=1.650，95%CI=0.454-5.991，P=0.447），premature rupture of membranes（OR=1.120，95%CI=0.672-1.867，P=0.664），low birth weight（OR=1.626，95%CI=0.455-5.809，P=0.454） and macrosomia（OR=1.932，95%CI=0.763-4.890，P=0.165），nor did it influence the weight（OR=0.037，95%CI=-49.746-146.518，P=0.333） and length（OR=0.009，95%CI=-0.350-0.445，P=0.813） of the newborn. Conclusion：The distance between living place of pregnant women and the main road <250 meters is not a risk factor of adverse pregnancy outcomes.