An outcome-wide analysis of maternal air pollution exposure and adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy

IF 3.7 2区环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES

Atmospheric Environment Pub Date : 2025-08-27 DOI:10.1016/j.atmosenv.2025.121511

Xueqi Li , Xiuling Zhu , Daijuan Chen , Yajie Zhao , Xixi Deng , Yongchi Zhan , Bing Guo , Tingting Xu , Xiaodong Wang

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引用次数: 0

Abstract

Background

While evidence shows that ambient air pollution negatively impacts pregnancy outcomes, its effect on pregnancy outcomes in intrahepatic cholestasis of pregnancy (ICP) patients remains underexplored.

Methods

We examined pre-pregnancy and gestational exposure to six pollutants (CO, NO₂, O₃, PM_2.5, PM₁₀, SO₂) across six exposure windows in relation to ten pregnancy outcomes in singleton (n = 1, 770) and twin (n = 945) ICP pregnancies. Logistic regression models and outcome-wide analysis were used, with stratification by fetal sex and ICP severity based on total bile acids (TBA) levels using a restricted cubic spline (RCS) model.

Results

SO₂ displayed significant effects on preterm birth and neonatal intensive care unit (NICU) in both singleton and twin pregnancy. Exposure to PM_2.5, PM₁₀ and SO₂ before pregnancy increased the risk of NICU admissions. Twin pregnancies and higher severity of ICP exhibit greater susceptibility to air pollution. Outcome-wide analysis found PM_2.5, SO₂, and O₃ significantly impacted adverse outcomes in singletons, while PM_2.5, SO₂, CO, NO₂, and O₃ had more impact in twins.

Conclusion

Air pollutant exposure increases the risk of adverse pregnancy outcomes in ICP, varying by exposure window, fetal sex, and ICP severity. Key pollutants like PM_2.5, SO₂, and O₃ impact both singleton and twin pregnancies.

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孕妇空气污染暴露与妊娠肝内胆汁淤积不良妊娠结局的结局分析

虽然有证据表明环境空气污染对妊娠结局有负面影响，但其对妊娠肝内胆汁淤积症（ICP）患者妊娠结局的影响仍未得到充分研究。方法通过6个暴露窗研究了妊娠前和妊娠期暴露于6种污染物（CO、NO2、O3、PM2.5、PM10、SO2）与单胎（n = 1770）和双胎（n = 945） ICP妊娠的10个妊娠结局的关系。采用Logistic回归模型和全结果分析，采用限制性三次样条（RCS）模型，根据胎儿性别和总胆汁酸（TBA）水平按ICP严重程度分层。结果so2对单胎妊娠和双胎妊娠的早产和新生儿重症监护病房（NICU）均有显著影响。孕前暴露于PM2.5、PM10和SO2会增加新生儿重症监护病房入院的风险。双胎妊娠和严重程度较高的ICP更容易受到空气污染的影响。结果分析发现，PM2.5、SO2和O3对单胎的不良结局有显著影响，而PM2.5、SO2、CO、NO2和O3对双胞胎的影响更大。结论空气污染物暴露增加了ICP患者不良妊娠结局的风险，并因暴露窗口、胎儿性别和ICP严重程度而异。PM2.5、二氧化硫和臭氧等主要污染物对单胎和双胎妊娠都有影响。

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

Atmospheric Environment 环境科学-环境科学

CiteScore

9.40

自引率

8.00%

发文量

458

审稿时长

53 days

期刊介绍： Atmospheric Environment has an open access mirror journal Atmospheric Environment: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atmospheric Environment is the international journal for scientists in different disciplines related to atmospheric composition and its impacts. The journal publishes scientific articles with atmospheric relevance of emissions and depositions of gaseous and particulate compounds, chemical processes and physical effects in the atmosphere, as well as impacts of the changing atmospheric composition on human health, air quality, climate change, and ecosystems.