科研之友
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摘要
The objective of this article is to review the main studies on the effects of air pollution on pregnancy outcomes (excluding death). It was researched and written simultaneously with a review of the influence of weather conditions on pregnancy outcomes, published in this volume, issue #2, of this journal. The articles were selected from Medline (R) database entries from 1990 through 2010 to ensure that we had the most recent data. The search showed a large number and wide diversity of studies of air pollution: cohorts, case-control, birth certificates, cross-sectional studies, with exposure measured most often by stationary air pollution monitors or personal air monitors. The pollutants studied most often are NO2, SO2, O-3, particulate matter, CO, and then suspended organic matter, polycyclic aromatic hydrocarbons, or indirectly, those produced by coal heating and proximity from roads or industrial areas. The studies showed associations with different pollutants, sometimes for the usual levels, although the odds ratios were often low (1.03 to 2.88). The studies' different conclusions can be explained by environmental conditions (pollution, climate), socioeconomic context, and the methods used : definitions of pregnancy outcomes, methods used to estimate pollutant concentrations, sample size, number of years studied, choice of exposure window, variety of the confounding factors and exclusion criteria taken into account. The diversity of the approaches makes any synthesis difficult, but shows the need to continue research and adapt it to the local setting. Better understanding of environmental factors could, by facilitating more effective prevention, help to reduce prematurity and problems of fetal development, improve the management of emergency services, and reduce health care costs.
- 出版日期2011-8
