Prenatal Exposure to PM_(2.5)and Its Specific Components and Risk of Hypertensive Disorders in Pregnancy:A Nationwide Cohort Study in China

摘要

Hypertensive disorders in pregnancy(HDP)are a leading cause of maternal mortality and adverse birth outcomes.Fine particulate matter(PM_(2.5))has been linked to HDP risk; however,limited studies have explored the relationships between specific chemical constituents of PM_(2.5)and HDP risk.Based on maternal data from the China Labor and Delivery Survey(CLDS),this study included a total of 67,659 participants from 95 participant hospitals in 25 provinces of China between March 1,2015,and December 31,2016.Maternal exposure to total PM_(2.5)mass and six main components during pregestation and pregnancy were estimated using the Combined Geoscience-Statistical Method.Multilevel logistic regression models were applied to quantify the associations,controlling for sociodemographic characteristics.We found that an interquartile range(IQR)increase in PM_(2.5)exposure during the second trimester was associated with a 14% increase in HDP risk(95% CI:2%,29%).We observed that black carbon(BC)and SO_4~(2-)had larger or comparable estimates of the effect than total PM_(2.5)mass.The association estimates were greater in the gestational hypertension group than in the group of pre-eclampsia and eclampsia.Our findings suggest that PM_(2.5)exposure and specific chemical components(particularly BC and SO_4~(2-))were associated with an increased HDP risk in China.