沈阳市2006-2010年大气污染与先天性心脏病病例对照研究

目的 探讨大气污染与出生缺陷即先天性心脏病（以下简称先心病）之间是否具有相关性。方法 以妊娠期间居住于沈阳市、末次月经位于2006年1月1日-2010年12月31日且分娩先心病缺陷患儿的孕产妇共计842例为研究对象，利用病例对照研究分析妊娠妇女在妊娠前后暴露于大气污染物中与分娩先心病患儿之间的关系。结果 沈阳市属中国大气污染较为严重的地区，每年的1-3月、11、12月是各污染物浓度均较高的时期，其中SO₂浓度最高时达到145.9 μg/m³，NO₂为541.4 μg/m³，PM10为163.6 μg/m³，每年的7月是SO₂、NO₂浓度较低的时期，SO₂为22 μg/m³，NO₂为27.2 μg/m³，PM10浓度最低月份在8月，为90.6 μg/m³，每月间污染物浓度差异有统计学意义。分娩先心病患儿孕妇在妊娠前2、3个月的SO₂暴露均值高于对照组，在妊娠第2、3个月的NO₂暴露均值高于对照组，妊娠前1、2、3个月、妊娠第1、2、3个月的所在地区PM10平均暴露浓度均高于对照组，且差异有统计学意义。结论 妊娠妇女孕前3个月及妊娠早期应避免暴露于大气污染物浓度较高的地区，因其可能会诱发胎儿先心病的发生。

Air pollution and congenital heart disease in Shenyang city between 2006 and 2010:a case-control study

Objective To explore whether air pollution associates with the incidence of congenital heart disease(CHD).Methods We recruited 842 puerperae with infants of CHD and reporting their last menstrual period between January 1,2006 and December 31,2010 as the cases and randomly selected 914 puerperae with normal infants as the controls in Shenyang city.Then we conducted a questionnaire survey among the participants to collect information on their exposure to air pollutants before and during the pregnancy and analyze the relationship between the exposure and CHD incidence.Results Air pollution was heavy and there were significant differences in monthly concentrations of air pollutants in Shenyang city during the period between 2006 and 2010;the season with heavier air pollution was from November of a year to March of the next year,with the highest monthly concentrations of 145.9μg/m³ for sulfur dioxide(SO₂),541.4 μg/m³ for nitrogen dioxide (NO₂),and 163.6 μg/m³ for particulate matter<10 microns in aerodynamic diameter (PM10) and the lowest monthly concentrations of SO₂ (22 μg/m³),NO₂ (27.2μg/m³) in July,and PM10 (90.6 μg/m³)in August of a year.The cases reported significantly higher mean exposure to SO₂ and NO₂ during 2nd and 3rd month before the pregnancy and higher mean exposure to PM10 from the 1st to 3rd month before the pregnancy and of the gestation than those of the controls.Conclusion Pregnant women's exposure to high concentrations of airborne contaminants during the 3 months prior to conception and during early pregnancy may associate with the incidence of congenital heart disease in their offsprings.