Association between outdoor light at night exposure and preterm birth and effect modification by pre-pregnancy stress: A national population-based retrospective cohort study

IF 6.1 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Ecotoxicology and Environmental Safety Pub Date : 2025-03-20 DOI:10.1016/j.ecoenv.2025.118054

Manman Chen , Qiongjie Zhou , Yuanyuan Li , Qu Lu , Anying Bai , Fangyi Ruan , Yandan Liu , Yu Jiang , Xiaotian Li

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引用次数: 0

Abstract

Background

Whether pre-pregnancy stress could modify the effects of outdoor artificial light at night (ALAN) on preterm birth (PB) has been unknown. This study aimed to explore the association between outdoor ALAN exposure and the risk of PB, as well as the effect modification by pre-pregnancy stress.

Methods

This national population-based retrospective cohort study included women of reproductive age (21–49 years) from the National Free Preconception Health Examination Project (NPHCP) across 220 counties in China, from 2010 to 2012. ALAN exposure was quantified using satellite data, and pre-pregnancy stress was assessed via a structured questionnaire focusing on life, friend, economic, and total stress. The primary outcomes were PB (28–37 weeks) and extremely PB (<28 weeks). Logistic regression models were used to estimate the risk odd ratios (ORs) of PB along with per interquartile range (IQR) increase in ALAN exposure, as well as the potential effect modification by pre-pregnancy stress. Stratified analysis was also conducted to explore differences across socioeconomic status.

Results

A total of 549,654 pregnant women were participated in this study. An IQR (8.0 nW/cm²/sr) increase in 1-year average ALAN exposure was associated with ORs of 1.08 (95 %CI: 1.03–1.13) and 1.03 (95 %CI: 1.02–1.04) for extremely PB and PB, respectively. Higher pre-pregnancy life stress levels were associated with a stronger association between outdoor ALAN exposure (1-year average) and extremely PB, with an odds ratio of 1.04 (95 % CI: 0.97–1.10) in the lower group and 1.16 (95 % CI: 1.08–1.24) in the higher group (P for difference = 0.017). Higher total, life, economic, and friend pre-pregnancy stress may amplify the effect of ALAN on PB risk. For instance, an IQR increment in ALAN exposure was associated with ORs of 1.02 (95 % CI: 1.00, 1.03) and 1.07 (95 % CI: 1.05, 1.10) among participants with low and high total stress (P for difference <0.001). Stratified analyses indicated more apparent effect modifications by pre-pregnancy stress in participants with lower educational levels, with non-farmer occupation, living in rural areas, and living in south regions.

Conclusions

Our findings suggest that higher pre-pregnancy stress levels may amplify the risk of PB associated with outdoor ALAN exposure, especially among women with lower educational levels, of non-farmer occupation, and living in rural areas or in south regions.

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夜间户外光照与早产的关系及孕前应激的影响：一项基于全国人群的回顾性队列研究。

背景：孕前应激是否会改变夜间室外人造光（ALAN）对早产（PB）的影响尚不清楚。本研究旨在探讨室外ALAN暴露与PB风险的关系，以及孕前应激对其影响的改变。方法：这项以全国人群为基础的回顾性队列研究纳入了2010年至2012年中国220个县的国家免费孕前健康检查项目（NPHCP）的育龄妇女（21-49岁）。使用卫星数据量化ALAN暴露，并通过结构化问卷评估孕前压力，重点关注生活、朋友、经济和总压力。主要结局为妊高征（28-37周）和极妊高征（结果：共有549,654名孕妇参与了本研究）。1年平均ALAN暴露的IQR （8.0 nW/cm2/sr）增加与极端PB和PB的or分别为1.08（95 %CI: 1.03-1.13）和1.03（95 %CI: 1.02-1.04）。较高的孕前生活压力水平与室外ALAN暴露（1年平均）和极端PB之间的相关性更强，较低组的比值比为1.04(95 % CI: 0.97-1.10)，较高组的比值比为1.16(95 % CI: 1.08-1.24) （P = 0.017）。较高的总压力、生活压力、经济压力和孕前朋友压力可能会放大ALAN对PB风险的影响。例如，在低总压力和高总压力的参与者中，ALAN暴露的IQR增加与or相关，分别为1.02（95 % CI: 1.00, 1.03）和1.07（95 % CI: 1.05, 1.10）。结论：我们的研究结果表明，较高的孕前压力水平可能会增加与户外ALAN暴露相关的PB风险，特别是在教育水平较低、非农业职业、生活在农村或南方地区的女性中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ecotoxicology and Environmental Safety 环境科学-毒理学

CiteScore

12.10

自引率

5.90%

发文量

1234

审稿时长

88 days

期刊介绍： Ecotoxicology and Environmental Safety is a multi-disciplinary journal that focuses on understanding the exposure and effects of environmental contamination on organisms including human health. The scope of the journal covers three main themes. The topics within these themes, indicated below, include (but are not limited to) the following: Ecotoxicology、Environmental Chemistry、Environmental Safety etc.