摘要：When discussing the association between birth weight and air pollution, previous studies mainly focus on the maternal trimester-specific exposures during pregnancy, whereas the possible associations between birth weight and weekly-specific exposures have been largely neglected. We conducted a nested 1:4 matched case-control study in Jinan, China to examine the weekly-specific associations during pregnancy between maternal fine particulate matter (aerodynamic diameter < 2.5 μm, PM2.5), nitrogen dioxide (NO2), and sulfur dioxide (SO2) exposure and birth weight, which is under a representative scenario of very high pollution levels. Ambient air monitoring data from thirteen monitoring stations and daily mean temperature data for Jinan during 2013–2016 were continuously collected. Birth data were obtained from the largest maternity and child care hospital of this city during 2014–2016. Individual exposures to PM2.5, NO2, and SO2 during pregnancy were estimated using an inverse distance weighting method. Birth weight for gender-, gestational age-, and parity-specific standard score (BWGAP z-score) was calculated as the outcome of interest. Distributed lag non-linear models (DLNMs) were applied to estimate weekly-specific relationship between maternal air pollutant exposures and birth weight. For an increase of per inter-quartile range in maternal PM2.5 exposure concentration during pregnancy, the BWGAP z-score decreased significantly during the 27th–33th gestational weeks with the strongest association in the 30th gestational weeks (standard deviation units decrease in BWGAP z-score: −0.049, 95% CI: −0.080 −0.017, in three-pollutant model). No significant association between maternal weekly NO2 or SO2 BWGAP z-score was observed. In conclusion, this study provides evidence that maternal PM2.5 exposure during the 27th–33th gestational weeks may reduce the birth weight in the context of very high pollution level of PM2.5.
