Association between outdoor light at night exposure and preterm birth and effect modification by pre-pregnancy stress: A national population-based retrospective cohort study

作者：Manman Chen, Qiongjie Zhou, Yuanyuan Li, Lu Qu, Anying Bai, Fangyi Ruan, Yandan Liu, Yu Jiang, Xiaotian Li · 发表于：Ecotoxicology and Environmental Safety · 年份：2025 · DOI：10.1016/j.ecoenv.2025.118054 · 被引用次数：4 · 研究领域：Impact of Light on Environment and Health、Circadian rhythm and melatonin、Ophthalmology and Visual Impairment Studies

BACKGROUND: Whether pre-pregnancy stress could modify the effects of outdoor artificial light at night (ALAN) on preterm birth (PB) has been unknown. This study aimed to explore the association between outdoor ALAN exposure and the risk of PB, as well as the effect modification by pre-pregnancy stress. METHODS: This national population-based retrospective cohort study included women of reproductive age (21-49 years) from the National Free Preconception Health Examination Project (NPHCP) across 220 counties in China, from 2010 to 2012. ALAN exposure was quantified using satellite data, and pre-pregnancy stress was assessed via a structured questionnaire focusing on life, friend, economic, and total stress. The primary outcomes were PB (28-37 weeks) and extremely PB (<28 weeks). Logistic regression models were used to estimate the risk odd ratios (ORs) of PB along with per interquartile range (IQR) increase in ALAN exposure, as well as the potential effect modification by pre-pregnancy stress. Stratified analysis was also conducted to explore differences across socioeconomic status. RESULTS: /sr) increase in 1-year average ALAN exposure was associated with ORs of 1.08 (95 %CI: 1.03-1.13) and 1.03 (95 %CI: 1.02-1.04) for extremely PB and PB, respectively. Higher pre-pregnancy life stress levels were associated with a stronger association between outdoor ALAN exposure (1-year average) and extremely PB, with an odds ratio of 1.04 (95 % CI: 0.97-1.10) in the lower group and 1.16 (9...