夜间户外人造光暴露可能增加孕妇产前抑郁和焦虑症状发生风险

The association between outdoor artificial light at night exposure and antenatal depression and anxiety symptoms: A retrospective cohort study in China

夜间户外人造光暴露与产前抑郁和焦虑症状之间的关联：一项中国回顾性队列研究

Author: Jingjing Liu, Yidan Cao, Tuyan Fan, Jiawen Zhao, Tianli Zhu, Hui Gao, Fangbiao Tao, Beibei Zhu.

Source: Environ Res.

DOI: 10.1016/j.envres.2024.120515

Abstract

Background: Outdoor artificial light at night (ALAN) has emerged as a significant source of environmental pollution, however its association with antenatal depression and anxiety symptoms has been rarely explored before.

Methods: This study was based on a cohort study conducted at the Maternal and Child Health Care Center in Ma’anshan City, Anhui Province, China, which ultimately included 1047 pregnant women. Depression and anxiety symptoms were evaluated utilizing the self-administered Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Scale (GAD-7), respectively. Exposure levels to outdoor ALAN were calculated utilizing satellite data and the participants’ usual addresses. Logistic regression and restricted cubic spline were used to assess the association between exposure to outdoor ALAN and depression and anxiety symptoms in pregnant women.

Results: After adjusting for confounding factors, high ALAN exposure during the pre-pregnancy period (OR_depression = 3.16, 95% CI: 1.14~8.75; OR_anxiety = 3.09, 95% CI: 1.51~6.28) and first trimester (OR_depression = 2.90, 95% CI: 1.13~7.45; OR_anxiety = 3.11, 95% CI: 1.55~6.25) were associated with increased risks of antenatal depression and anxiety symptoms. Restricted cubic spline analyses showed the above associations were not nonlinear.

Conclusion: Our study is the first to propose that exposure to high levels of outdoor ALAN three months before pregnancy and during the first trimester of pregnancy is a risk factor for antenatal depression and anxiety symptoms.

Keywords: artificial light at night; depression; anxiety; pregnancy; retrospective cohort study

摘要

背景：夜间户外人造光（Outdoor artificial light at night，ALAN）已成为重要的环境污染源，然而，它与产前抑郁和焦虑症状之间的关联之前却很少被探讨。

方法：本研究基于在中国安徽省马鞍山市妇幼保健院开展的一项队列研究，最终纳入了1047名孕妇。分别采用自评患者健康问卷（PHQ-9）和7项广泛性焦虑量表（GAD-7）评估抑郁和焦虑症状。利用卫星数据和参与者常住地址计算其户外ALAN暴露水平。采用逻辑回归和限制立方样条分析评估孕妇户外ALAN暴露与抑郁和焦虑症状之间的关联。

结果：在调整混杂因素后，孕前（抑郁OR=3.16，95% CI：1.14—8.75；焦虑OR=3.09，95% CI：1.51—6.28）和孕早期（抑郁OR=2.90，95% CI：1.137.45；焦虑OR=3.11，95% CI：1.55—6.25）高ALAN暴露与产前抑郁和焦虑症状风险增加相关。限制性立方样条分析显示上述关系不是非线性的。

结论：本研究首次提出，孕前三个月和孕早期高水平ALAN暴露是产前抑郁和焦虑症状的风险因素。

关键词：夜间人造光；抑郁；焦虑；妊娠；回顾性队列研究