Efeitos dos poluentes do ar e da temperatura no desencadeamento do parto prematuro
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2022-07-18
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Universidade Estadual Paulista (Unesp)
Resumo
Este trabalho tem por objetivo avaliar a exposição da gestante aos poluentes do ar em sua somatória de cinco, dez e 15 dias anteriores ao parto, e da temperatura ambiente máxima diária, na defasagem de um, três e cinco dias anteriores ao parto, e analisar o efeito desses poluentes e da temperatura sobre o desencadeamento do parto prematuro. Trata-se de estudo longitudinal, com dados todos os nascidos vivos de mulheres residentes nos municípios de Cubatão, Ribeirão Preto e São José dos Campos nos anos de 2017 a 2019, excluindo os com peso menor de 500 gramas, os partos gemelares e trigemelares, bem como os fetos com mal-formação congênita. A variável dependente, prematuridade, foi categorizada como desfavorável ≤ 36 semanas e 6/7 e favorável ≥ 37 semanas de gestação, e as independentes foram idade materna, estado civil, escolaridade, número de filhos mortos, número de consultas e mês do início do pré-natal. Os poluentes do ar analisados foram PM10, NO2 e O3 com dados acumulados de cinco, dez e 15 dias anteriores ao parto, e temperatura máxima diária, com defasagem de um, três e cinco dias, anteriores ao parto. As análises utilizadas foram os modelos de regressão logística hierarquizada em três níveis: distal, intermediário e proximal, e regressão linear. Foram 55.855 nascidos vivos, sendo incluídos 23.822 (42,7%) que atenderam aos critérios de inclusão. Foi significativa a exposição materna ao PM10 com dez dias anteriores ao parto, sem considerar o efeito da temperatura (OR: 1,23) em Cubatão, sendo que para os outros poluentes e defasagens de temperatura, não houve significância estatística.
This study aims to evaluate the exposure of pregnant women to air pollutants in their sum of five, ten, and 15 days before delivery, and the maximum daily ambient temperature, in the lag of one, three, and five days before delivery, and analyze the effect of these pollutants and temperature on the triggering of preterm birth. This is a longitudinal study, with data on all live births of women living in the municipalities of Cubatão, Ribeirão Preto, and São José dos Campos in the years 2017 to 2019, excluding those weighing less than 500 grams, twins, and triplets, as well as fetuses with congenital malformations. The dependent variable, prematurity, was categorized as unfavorable ≤ 36 weeks and 6/7 and favorable ≥ 37 weeks of gestation, and the independent variables were maternal age, marital status, schooling, number of dead children, number of consultations, and month of beginning of the period. prenatal. The air pollutants analyzed were PM10, NO2, and O3 with accumulated data from five, ten, and 15 days before calving, and maximum daily temperature, with a lag of one, three, and five days, before calving. The analyzes used were hierarchical logistic regression models at three levels: distal, intermediate, and proximal, and linear regression. There were 55,855 live births, including 23,822 (42.7%) who met the inclusion criteria. Maternal exposure to PM10 ten days before delivery was significant, without considering the effect of temperature (OR: 1.23) in Cubatão, and for other pollutants and temperature lags, there was no statistical significance
This study aims to evaluate the exposure of pregnant women to air pollutants in their sum of five, ten, and 15 days before delivery, and the maximum daily ambient temperature, in the lag of one, three, and five days before delivery, and analyze the effect of these pollutants and temperature on the triggering of preterm birth. This is a longitudinal study, with data on all live births of women living in the municipalities of Cubatão, Ribeirão Preto, and São José dos Campos in the years 2017 to 2019, excluding those weighing less than 500 grams, twins, and triplets, as well as fetuses with congenital malformations. The dependent variable, prematurity, was categorized as unfavorable ≤ 36 weeks and 6/7 and favorable ≥ 37 weeks of gestation, and the independent variables were maternal age, marital status, schooling, number of dead children, number of consultations, and month of beginning of the period. prenatal. The air pollutants analyzed were PM10, NO2, and O3 with accumulated data from five, ten, and 15 days before calving, and maximum daily temperature, with a lag of one, three, and five days, before calving. The analyzes used were hierarchical logistic regression models at three levels: distal, intermediate, and proximal, and linear regression. There were 55,855 live births, including 23,822 (42.7%) who met the inclusion criteria. Maternal exposure to PM10 ten days before delivery was significant, without considering the effect of temperature (OR: 1.23) in Cubatão, and for other pollutants and temperature lags, there was no statistical significance
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Poluentes do Ar, Poluição, Temperatura, Prematuridade, Parto Prematuro, Air Pollutants, Pollution, Temperature, Prematurity, Premature birth, Poluentes, Ar - poluição, Ozônio, Trabalho de parto prematuro