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Article(id=1321169847216619762, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169735128043598, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146068, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1727625600000, receivedDateStr=2024-09-30, revisedDate=1733760000000, revisedDateStr=2024-12-10, acceptedDate=1744387200000, acceptedDateStr=2025-04-12, onlineDate=1792921037725, onlineDateStr=2026-10-25, pubDate=1752076800000, pubDateStr=2025-07-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921037725, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921037725, creator=13701087609, updateTime=1792921037725, updator=13701087609, issue=Issue{id=1321169735128043598, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='7', pageStart='769', pageEnd='896', issueExtLink='null', onlineDate='null', pubDate='1752076800000', pubDateStr='2025-07-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921011000, creator='13701087609', updateTime=1792921011000, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=872, endPage=876, ext={EN=ArticleExt(id=1321169847430529267, articleId=1321169847216619762, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Research progress on the effect of nighttime light exposure on maternal and child health: a review, columnId=1320427713148597230, journalTitle=Chinese Journal of Public Health, columnName=Review, runingTitle=null, highlight=null, articleAbstract=

Artificial light, while playing a crucial role in enhancing productivity and enriching nightlife, has also given rise to the public health issue of excessive nighttime light exposure. This issue primarily manifests as a disruption of natural light cycles, leading to circadian rhythm disorders in humans, negatively impacting sleep quality, mood, and cardiovascular health. Consequently, it has been recognized as a novel environmental pollutant. Pregnant women, as a group highly sensitive to environmental pollution, have garnered significant attention regarding their health status. This review aims to explore the current status of nighttime light exposure, assessment methods, and its potential impacts on pregnant women and newborns, along with the underlying mechanisms, in order to provide scientific theoretical support for preventing excessive nighttime light exposure and promoting maternal and child health.

, authors=Rui SHAN1, Baolin WANG2, Fangbiao TAO2, 3, Ying TANG1, 3, authorsList=Rui SHAN, Baolin WANG, Fangbiao TAO, Ying TANG, authorCompany=null, correspAuthors=Ying TANG, authorNote=null, correspAuthorsNote=
TANG Ying, E-mail: .
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人造光虽然在提高生产效率、丰富夜间生活方面发挥着重要作用，但同时也引发了过度夜间光照这一公共卫生问题。该问题主要表现为对自然光周期的干扰，进而导致人体生物钟紊乱，对睡眠质量、情绪状态以及心血管健康产生负面影响，因此被认定为一种新型的环境污染物。孕妇作为对环境污染高度敏感的群体，其健康状况受到广泛关注。本综述旨在探讨当前夜光暴露的现状、评估方法以及其对孕妇和新生儿可能产生的影响及其潜在机制，以期为预防过度夜光暴露、促进母婴健康提供科学的理论支持。

, authors=单瑞1, 汪宝琳2, 陶芳标2, 3, 唐颖1, 3, *, *, authorsList=单瑞, 汪宝琳, 陶芳标, 唐颖, authorCompany=null, correspAuthors=唐颖, authorNote=

单瑞（1999—），硕士在读，研究方向：环境暴露和生殖健康

, correspAuthorsNote=
唐颖，E-mail：
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单瑞（1999—），硕士在读，研究方向：环境暴露和生殖健康

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单瑞（1999—），硕士在读，研究方向：环境暴露和生殖健康

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夜光暴露对母婴健康影响研究进展
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单瑞 1 , 汪宝琳 2 , 陶芳标 2, 3 , 唐颖 1, 3, *, *
中国公共卫生 | 综　述 2025,41(7): 872-876
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中国公共卫生 |综　述 2025 , 41 (7) : 872 -876
夜光暴露对母婴健康影响研究进展
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单瑞（1999—），硕士在读，研究方向：环境暴露和生殖健康

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单瑞（1999—），硕士在读，研究方向：环境暴露和生殖健康

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单瑞1, 汪宝琳2, 陶芳标2, 3, 唐颖1, 3, *, *
作者信息
  • 1安徽医科大学护理学院母婴与儿童护理学教研室，合肥 230032
  • 2安徽医科大学公共卫生学院儿少卫生与妇幼保健学系，合肥 230032
  • 3出生人口健康教育部重点实验室 安徽省环境与人口健康重点实验室，合肥 230032
通讯作者:
唐颖，E-mail：
作者简介:

单瑞（1999—），硕士在读，研究方向：环境暴露和生殖健康

Research progress on the effect of nighttime light exposure on maternal and child health: a review
Rui SHAN1, Baolin WANG2, Fangbiao TAO2, 3, Ying TANG1, 3
Affiliations
  • 1School of Nursing, Anhui Medical University, Hefei 230032, China
  • 2Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
  • 3MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health&Aristogenics, Hefei 230032, China
    • Corresponding Author:
    TANG Ying, E-mail: .
出版时间: 2025-07-10 doi: 10.11847/zgggws1146068
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摘要
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人造光虽然在提高生产效率、丰富夜间生活方面发挥着重要作用，但同时也引发了过度夜间光照这一公共卫生问题。该问题主要表现为对自然光周期的干扰，进而导致人体生物钟紊乱，对睡眠质量、情绪状态以及心血管健康产生负面影响，因此被认定为一种新型的环境污染物。孕妇作为对环境污染高度敏感的群体，其健康状况受到广泛关注。本综述旨在探讨当前夜光暴露的现状、评估方法以及其对孕妇和新生儿可能产生的影响及其潜在机制，以期为预防过度夜光暴露、促进母婴健康提供科学的理论支持。

夜光暴露  /  昼夜节律  /  母婴健康

Artificial light, while playing a crucial role in enhancing productivity and enriching nightlife, has also given rise to the public health issue of excessive nighttime light exposure. This issue primarily manifests as a disruption of natural light cycles, leading to circadian rhythm disorders in humans, negatively impacting sleep quality, mood, and cardiovascular health. Consequently, it has been recognized as a novel environmental pollutant. Pregnant women, as a group highly sensitive to environmental pollution, have garnered significant attention regarding their health status. This review aims to explore the current status of nighttime light exposure, assessment methods, and its potential impacts on pregnant women and newborns, along with the underlying mechanisms, in order to provide scientific theoretical support for preventing excessive nighttime light exposure and promoting maternal and child health.

nighttime light exposure  /  circadian rhythm  /  maternal and child health
单瑞, 汪宝琳, 陶芳标, 唐颖. 夜光暴露对母婴健康影响研究进展. 中国公共卫生, 2025 , 41 (7) : 872 -876 . DOI: 10.11847/zgggws1146068
Rui SHAN, Baolin WANG, Fangbiao TAO, Ying TANG. Research progress on the effect of nighttime light exposure on maternal and child health: a review[J]. Chinese Journal of Public Health, 2025 , 41 (7) : 872 -876 . DOI: 10.11847/zgggws1146068
正文
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随着轮班制度、加班、熬夜日益普遍，人造光源如同雨后春笋般迅速渗透至我们日常生活中，导致夜光暴露问题日益严峻，并威胁着城市人口健康[1]。近年来，夜光暴露对母婴健康所产生的不良影响，已成为一个新兴且备受关注的研究领域。维护母婴健康可减轻疾病负担、促进家庭和谐，这是维持社会稳定，保障人类生命健康的关键环节。鉴于此，本文对夜光暴露及其测量方法进行综述，总结夜光暴露对妊娠期母体健康、不良妊娠结局以及新生儿生长发育所构成的潜在危害，并分析其内在机制，为夜间光暴露对母婴健康的不利影响提供理论依据，也为我国光污染治理和公共卫生政策的制定提供科学依据。
1　夜光暴露概述
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1.1　夜光暴露现状
随着照明设施的广泛普及，夜光暴露已成为一个普遍且严重的问题。随着城市化进程步伐的日益加快，全球室内与室外人造光源的照明范围正以每年2.2%的速率显著扩张[1]。这一趋势导致全球范围内超过80%的人口正遭受着严重光污染的侵扰[1]。除了陆地范围内，海洋地区同样面临着光污染的困扰[2]。对中国而言，大约有88%人口和30%地区受到光污染的影响[3]。夜光暴露对人体的危害是多方面的，可通过扰乱人体昼夜节律，进而引起多种疾病的发生[4]。
1.2　夜光暴露测量方法
夜光暴露的测量方法包括直接测量和间接测量。直接测量的工具有照度计、手持式夜光测量仪和腕带式测量设备等。照度计是一种专门用来测量光照强度的仪器，可以评估特定范围的光照水平，如日常生活环境和一般公共场所。日本的一项研究通过使用照度计来检测857名老年人室内夜光暴露水平[5]。手持夜光测量仪是一种便捷的测量工具，常用于测量小范围内的夜光亮度，如住宅区、街道等场景。腕带式测量设备如Axivity AX3，专为精确测量个体所接触的光暴露而设计，尤其在评估夜间室内光暴露水平方面展现出卓越的性能。英国Biobank项目，便是通过使用该设备来捕获10万参与者连续7 d的24 h光照数据[6]。间接测量包括遥感技术和地面观测站。遥感技术，是一种远程探测技术，可测量大范围区域，如城市、农田、水库、工业区等。当前有研究通过卫星遥感技术手段，对孕妇居住环境的夜间照明状况进行监测与分析[7]。地面观测站通过所配置的光强度计来测量特定地点的夜光暴露强度，如商业区、居民区、高速公路及活动现场。照度计便于携带且功能多样，但仅限于测量光照强度。手持式测量仪操作简单、灵敏度高，适用性广，成本较高。遥感技术覆盖范围广，时效性强，适合动态监测，但易受天气影响。地面观测站提供精确数据，但天气限制可能导致不准确。腕带式测量仪器操作便捷、测量精确，能实时追踪环境光暴露，但易受袖口遮挡影响。目前，遥感技术是常用的夜光暴露测量方法，中国武汉大学团队研制的“珞珈一号”卫星提高了空间分辨率[8–9]。随着科技进步，未来将有更精确的技术测量夜光暴露，为研究提供数据支持。
2　夜光暴露与孕妇健康
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2.1　妊娠糖尿病
妊娠糖尿病是指女性在妊娠期间才首次诊断出糖尿病，是临床中最常见的妊娠相关疾病之一[10]。中国一项前瞻性队列研究调查了9 120名无糖尿病病史孕妇居住地室外夜光暴露水平，发现孕期各阶段高水平的户外夜光暴露可能会增加妊娠期糖尿病的风险，包括妊娠中期室外夜光暴露可能导致孕妇口服糖耐量受损，以及妊娠早期高水平室外夜光暴露会对孕妇2 h口服葡萄糖耐量产生负面影响[7]。其中的机制可能与夜光暴露抑制褪黑激素分泌，使昼夜节律紊乱，从而干扰葡萄糖稳态，加速胰岛素抵抗有关[7]。褪黑素是一种控制机体昼夜节律的激素，并呈现出昼低夜高的波动趋势，持续恒定光照抑制褪黑素分泌，导致昼夜节律紊乱[11]。有研究发现褪黑素产生减少，会诱导胰岛素抵抗，葡萄糖不耐受，进一步产生妊娠期糖尿病[12]。昼夜节律（circadian rhythm）也称近日节律，参与了生物体所有的生理活动[13]，人体内有300多种生理活动随昼夜交替而呈现出相应的节律变化[13]，其中包括血糖代谢[14]。当机体长期处于夜班轮班和夜光暴露状态时，会导致昼夜节律紊乱，破坏胰岛β细胞的功能，引起氧化应激、线粒体功能障碍及影响β细胞中的囊泡运输，最终导致葡萄糖刺激的胰岛素分泌减少，从而促进糖尿病的发生[14–15]。因此，尤其应该将夜光暴露作为重要影响因素加以防范。
2.2　妊娠高血压
妊娠期高血压疾病是妊娠期特有的、常见的并发症，是全世界孕产妇和围产儿死亡的主要病因之一，不仅体现在孕妇高血压严重程度方面，更重要的是其发展阶段中子痫前期的临床表现极具复杂化[16]。临床发现孕妇夜间血压较高，而褪黑素水平随血压升高而降低，这进一步证明了褪黑素调节血压的关键作用[16]。有研究发现长期暴露于夜光下的人群，血压会升高，其机制可能与褪黑素介导的交感、副交感之间的相互作用以及血管扩张有关[10]。此外，子痫前期与胎盘血管损伤，大量抗血管形成因子释放入血，并引起母体血管内皮损伤和功能障碍[17]。其中抗血管形成因子（soluble fms-like tyrsine kinase-1, sFlt-1）参与毛细血管损伤和胎盘血管重铸障碍，可引起血压升高[17]，其水平变化与子痫前期严重程度呈正相关[18]。然而褪黑素具有清除自由基和抗氧化功能，可通过刺激内源性抗氧化酶来减少胎盘细胞死亡和维护胎盘血管，在防止血压升高中发挥关键作用[19]。血红素氧合酶1（Heme Oxygenase-1, HO-1）是一种抗氧化酶，其活性变化与表达可参与血压调节，已有研究发现妊娠高血压患者血清HO-1水平明显低于正常孕妇[20]。然而，褪黑素在恢复HO-1水平方面展现出积极效应，能够显著降低血压[21]。DNA甲基化是参与基因调控最明确的表观遗传机制，可通过环境等刺激因素产生反应，并引起疾病发生[22]。前期研究发现子痫前期（preeclampsia，PE）的发生可能与DNA甲基化有关[23]。TIMP3基因，在PE胎盘中DNA呈现低甲基化，并介导其基因表达上调[24]。因此可推测，DNA甲基化可能通过影响关键基因的表达，在子痫前期疾病的发生过程中发挥重要作用[25]。
2.3　睡眠
由于人们生活习惯和行为方式改变，导致人们在夜间过度暴露于夜光之下。美国有研究发现，夜光暴露水平越高的地区，引起其居民睡眠时间缩短的风险越高[24]。有学者对近2万名美国成人的数据进行分析，发现随着户外夜光暴露强度的增加，其睡眠效率呈现下降趋势，且入睡和起床时间均显现出延迟趋势。由于轮班制的工作性质出现以及夜间灯光照射频率增加[26]，孕妇成为易受环境因素影响的重点关注人群。针对孕妇群体的研究揭示，在夜间接受100勒克斯光照强度的暴露条件下，孕妇的主观睡眠质量以及快速眼动睡眠阶段出现减少，与此同时，浅睡眠阶段和睡眠觉醒次数则呈现增加趋势[27]。光暴露是调节人类和动物生物节律的关键外部因素，通过影响昼–夜循环和睡眠–觉醒周期对生物节律和睡眠质量产生重要作用[28]。生物节律维持正常的生理性睡眠。然而，不规律的光照节律可能会干扰甚至损害这些内在的生物节律,导致睡眠质量降低[29]。研究表明，睡眠障碍与生物钟基因CLOCK，PER，CRY密切相关，一旦这些基因受到昼夜节律的干扰，均可能触发睡眠障碍[30]。
2.4　焦虑抑郁
情绪与孕妇身心健康息息相关。产前抑郁是孕妇常见的心理疾病，临床表现为易怒、失眠、绝望，甚至有自杀倾向。轮班工人的昼夜节律紊乱会导致炎症增加，并在一组对照实验中发现，轮班工作的人炎症标志物水平明显高于对照组[31]。而人体内某些炎症因子传递神经内分泌信号，焦虑越严重，体内炎症反应越强。先前的研究表明，免疫系统中的白细胞介素、C–反应蛋白、TNF-α等炎症因子与焦虑症有关[31]。而褪黑素具有抗炎作用[32]，光线对褪黑素分泌的抑制作用会削弱其抗炎作用，从而诱导焦虑抑郁的发生[33]。此外，夜光暴露可导致昼夜节律紊乱，并参与生物钟基因表达水平变化，从而增加抑郁风险。有研究者将产前抑郁孕妇（研究组）和正常孕妇（对照组）作为试验对象，并发现2组孕妇的生物钟基因水平变化均呈昼夜节律性，但研究组节律变化波动幅度较小以及节律性不明显[34]，这进一步增强了产前抑郁与昼夜节律的关系。综上所述，光照对人体的心理健康密切相关，可通过降低夜光暴露水平来预防产前抑郁，维护孕妇心理健康。
3　夜光暴露与不良妊娠结局
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3.1　早产
早产是一个复杂现象，并对于子代的生长发育有不良影响。分娩是受昼夜节律调控的过程，而褪黑素对妊娠具有保护作用[35]。近年来的研究表明轮班制女性存在昼夜节律紊乱，继而引起早产[11]。其机制与夜光暴露抑制褪黑素分泌，削弱清除自由基功能，从而增加胎儿受氧化应激损伤风险有关[36]。此外，还有研究表明夜间卧室的光照强度与早产风险之间存在显著关联，其风险值随着光照强度的增强而增加[37]。此外，胎盘可以被认为是一个昼夜节律性器官，当周围环境光信号发生改变时，昼夜节律也会随之受到影响，从而影响分娩时间[10]。
3.2　自然流产
自然流产是指在受孕28周之前，由于某种原因导致的妊娠终止。有实验表明，持续光暴露下的小鼠其流产率呈现上升趋势[38]。这可能与生物钟紊乱和肠道菌群失调有关。首先，夜光暴露可扰乱人体生物钟系统。例如，BMAL1（brain and muscle arnt-like 1）基因在女性生殖系统中均有表达，其昼夜节律性表达参与了妊娠的维持[11]。BMAl1基因改变与流产有关，它可通过多种机制影响妊娠时期激素分泌，从而引起妊娠丢失[39]。如BMAl1表达下降会使卵巢和输卵管中活性氧增加，从而影响卵母细胞受精、早期胚胎发育和着床，导致胚胎丢失[40]。综上所述，夜光暴露作为影响流产的重要环境因素，可参与生物钟紊乱对母体产生不利影响。其次，有动物实验表明，小鼠在不同光照条件下肠道菌群组成会随昼夜节律变化而变化，这暗示夜光暴露对肠道菌群昼夜节律有重要影响。肠道菌群在生物钟进化过程中形成与宿主相互平衡和制约关系[41–42]，当平衡被打破时，机体将会产生一系列生理改变。肠道内存在数量庞大的微生物群体，可调控宿主多项生理变化，被视为一个新兴的人类生态系统[43]。值得注意的是，肠道菌群与生殖系统密切关联。近年来，关于肠–子宫内膜轴在自然流产发病机制中作用的相关证据已较为充分[43]。具体而言，肠道菌群可产生多种炎症介质如脂多糖（lipopolysaccharide，LPS），该介质可刺激机体产生免疫反应[43]。肠道菌群失衡会使肠道的通透性增强，加速LPS进入体循环，此过程被称为“肠漏”。肠漏现象可导致细菌成分透过受损的肠膜屏障进入体循环，激活NALP-3炎症小体，引发子宫内膜组织产生炎症反应，进一步引起流产[43]。此外，父代肠道微生物群的失衡可能对子代的生殖系统引发显著的代际效应，这表明当可调节的肠道–生殖轴受到干扰时，可能会在某种程度上影响即将形成的胎盘的中枢功能[44]。
3.3　低出生体重和巨大儿
有关轮班女性的研究显示，扰乱昼夜节律可引起早产及低体重儿的出生[11]。中国台湾省的一项研究发现，持续轮班制工作的女性所生的新生儿体重明显低于持续日间工作女性[45]。轮班制受夜光暴露影响改变了行为和导致生理功能受损，甚至可在孕晚期及围生期扰乱光/暗周期，对子代的行为和代谢功能产生不利影响，增加低体重儿出生的风险[11]。母体激素释放模式的改变是影响胎儿生长发育的关键因素[46]。当激素的分泌节律受到干扰时，可能会对新生儿体重产生不利影响，导致低出生体重风险增加。此外，夜光暴露会导致妊娠糖尿病风险增加，导致孕妇分娩巨大儿的风险也会随之升高。由此可见，孕妇在孕期应该避免过度夜光暴露。
4　新生儿生长发育
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新生儿生长发育是个重要且复杂的过程，包括各器官、体重、身高的发育。良好的环境对新生儿生长发育极其关键，过度的夜间光线暴露会扰乱新生儿生长发育所需的明暗周期环境，不利于新生儿生长发育。有研究发现通过为新生儿提供不同亮度的循环光照，以建立周期性光照环境，可以帮助早产儿形成规律的睡眠–清醒周期，促进生长激素分泌，从而稳定脑神经发育[47]。夜光暴露干扰生长发育的机制与新生儿昼夜节律的失调以及睡眠形态紊乱紧密相关。快速眼动睡眠对于胎儿的神经系统发育至关重要，睡眠形态紊乱可影响神经发育的可塑性，缺乏可塑性可影响智力发育，并导致记忆和学习能力下降[48]。生长激素分泌具有昼夜节律性，夜间深度睡眠时分泌最为旺盛[49]。因此，如果缺乏充足和高质量的睡眠，会影响生长激素的分泌。生长激素对骨骼、内脏和全身生长具有积极作用，如分泌受到影响，对新生儿生长发育也不利。因此，可通过为新生儿创造所需的夜间光线环境，维护新生儿生长发育。
5　小　结
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随着城市化进程加快，夜光暴露问题日益成为公共卫生领域的关注焦点，其对母婴健康的潜在威胁正逐步受到各界的重视。当前，遥感技术在宏观层面精准捕捉城市夜间光污染的分布，而腕带式设备则在微观层面实现了个体夜间光照暴露的精确测量，两者相辅相成，为夜光暴露研究提供了有力工具。本文聚焦于夜光暴露对昼夜节律的干扰，并以此为切入点，深入探讨夜光暴露对母婴健康的隐匿影响。鉴于现有研究对夜光暴露与母婴健康关联及其机制的探索尚显不足，未来研究应聚焦于昼夜节律光周期对褪黑素、DNA甲基化和激素分泌的调控机制，及其对母体生理状态、妊娠进展及新生儿发育的潜在影响。这不仅可深化对夜光暴露健康效应的理解，也有助于为优化母体健康管理、提升妊娠质量、保障新生儿健康发育提供坚实的科学依据。

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doi: 10.11847/zgggws1146068
  • 接收时间：2024-09-30
  • 首发时间：2026-10-25
  • 出版时间：2025-07-10
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  • 收稿日期：2024-09-30
  • 修回日期：2024-12-10
  • 录用日期：2025-04-12
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    1安徽医科大学护理学院母婴与儿童护理学教研室，合肥 230032
    2安徽医科大学公共卫生学院儿少卫生与妇幼保健学系，合肥 230032
    3出生人口健康教育部重点实验室 安徽省环境与人口健康重点实验室，合肥 230032

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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