Environmental exposure to outdoor artificial light at night during pregnancy and fetal size: A prospective cohort study

Authors：Lei Zhang , Wanjun Yin , Wenjie Yu , Peng Wang , Haixia Wang , Xiujun Zhang , Peng Zhu

Source：Sci Total Environ. 2023 Jul 20;883:163521.

DOI:10.1016/j.scitotenv.2023.163521

Abstract：Background:Previous studies suggested outdoor artificial light at night (ALAN) exposure may contribute to children and adult obesity, but less is known about the associations of outdoor ALAN exposure during pregnancy with fetal size.

Methods: From 2015 to 2021, 6210 mother-child pairs were included. Average outdoor ALAN levels during pregnancy were measured using satellite imaging data. Fetal biparietal diameter, head circumference, abdominal circumference (AC), and femur length were measured before delivery with ultrasonography. We also collected anthropometric birth outcomes, including birth length, birth weight, macrosomia, low birth weight, small for gestational age, and large for gestational age at delivery. Multivariable linear regression models and binary logistic regression models were used to examine the potential associations of outdoor ALAN with fetal size adjusting for a broad set of potential confounds.

Results: An IQR (14.87 nW/cm2/sr) increase in outdoor ALAN during pregnancy was associated with 1.30 (β = 1.30, 95 % CI: 0.31,2.29) higher AC percentiles and 13 % (OR = 1.13, 95 % CI: 1.00,1.27) higher odds of macrosomia after adjusting confounders. In sex stratification analysis, an IQR (14.87 nW/cm2/sr) increase in outdoor ALAN during pregnancy was associated with 1.65 (β = 1.65, 95 % CI: 0.24,3.06) higher fetal AC percentiles and 27 % (OR = 1.27, 95 % CI: 1.06,1.53) higher odds of macrosomia in females.

Conclusions: Our findings suggest that higher outdoor ALAN exposure during pregnancy is associated with larger fetal AC and a higher risk of macrosomia, particularly in the female fetus. Future studies are needed to verify these preliminary findings and identify potential mechanisms for the association.

摘要：

背景：先前的研究表明，夜间户外人造光（ALAN）暴露可能会导致儿童和成人肥胖，但人们对孕期户外ALAN暴露与胎儿大小的关系知之甚少。

方法：从 2015 年到 2021 年，共纳入了 6210 对母婴。利用卫星成像数据测量了孕期室外ALAN的平均水平。胎儿双顶径、头围、腹围（AC）和股骨长度在分娩前通过超声波进行测量。我们还收集了出生时的人体测量结果，包括出生身长、出生体重、巨大儿、低出生体重、胎龄小和胎龄大。我们使用多变量线性回归模型和二元逻辑回归模型来检验户外ALAN与胎儿大小的潜在联系，并对一系列潜在混杂因素进行了调整。

结果：在调整混杂因素后，孕期室外ALAN的IQR（14.87 nW/cm2/sr）增加与AC百分位数增加1.30 (β = 1.30, 95 % CI: 0.31,2.29)和巨大胎儿几率增加13 % (OR = 1.13, 95 % CI: 1.00,1.27)相关。在性别分层分析中，怀孕期间室外ALAN的IQR（14.87 nW/cm2/sr）增加与胎儿AC百分位数增加1.65 (β = 1.65, 95 % CI: 0.24,3.06)和女性巨头症几率增加27 % (OR = 1.27, 95 % CI: 1.06,1.53)相关。

结论：我们的研究结果表明，孕期较高的室外 ALAN 暴露与胎儿较大的 AC 值和较高的巨大胎儿畸形风险有关，尤其是女性胎儿。未来的研究需要验证这些初步发现，并确定这种关联的潜在机制。