孕期空气污染与儿童认知及心理运动发育：六项欧洲出生队列研究
Air pollution during pregnancy and childhood cognitive and psychomotor development: six European birth cohorts.
作者信息
Guxens Mònica, Garcia-Esteban Raquel, Giorgis-Allemand Lise, Forns Joan, Badaloni Chiara, Ballester Ferran, Beelen Rob, Cesaroni Giulia, Chatzi Leda, de Agostini Maria, de Nazelle Audrey, Eeftens Marloes, Fernandez Mariana F, Fernández-Somoano Ana, Forastiere Francesco, Gehring Ulrike, Ghassabian Akhgar, Heude Barbara, Jaddoe Vincent W V, Klümper Claudia, Kogevinas Manolis, Krämer Ursula, Larroque Béatrice, Lertxundi Aitana, Lertxuni Nerea, Murcia Mario, Navel Vladislav, Nieuwenhuijsen Mark, Porta Daniela, Ramos Rosa, Roumeliotaki Theano, Slama Rémy, Sørensen Mette, Stephanou Euripides G, Sugiri Dorothea, Tardón Adonina, Tiemeier Henning, Tiesler Carla M T, Verhulst Frank C, Vrijkotte Tanja, Wilhelm Michael, Brunekreef Bert, Pershagen Göran, Sunyer Jordi
机构信息
From the aCenter for Research in Environmental Epidemiology, Barcelona, Spain; bHospital del Mar Research Institute, Barcelona, Spain; cSpanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; dInserm, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, U823, Grenoble, France; eUniversity Grenoble-Alpes, Institut Albert Bonniot, Grenoble, France; fDepartment of Epidemiology Lazio Regional Health Service, Rome, Italy; gUniversity of Valencia, Valencia, Spain; hCenter for Public Health Research (CSISP)/FISABIO, Valencia, Spain; iInstitute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; jDepartment of Social Medicine, University of Crete, Heraklion, Greece; kInserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Epidemiology of Diabetes, Obesity and Kidney Disease: Lifelong Approach Team, Paris, France; lUniversity Paris-Sud, UMRS 1018, France; mCentre for Environmental Policy, Imperial College London, United Kingdom; nBiomedical Research Center, University of Granada; Granada, Spain; oLaboratory of Medical Investigations, San Cecilio University Hospital; Granada, Spain; pPreventive Medicine and Public Health, University of Oviedo, Oviedo, Spain; qDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands; rThe Generation R Study, Erasmus Medical Centre, Rotterdam, The Netherlands; sDepartment of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; tIUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; uNational School of Public Health, Athens, Greece; vEpidemiology and clinical research unit, Hopital Beaujon, APHP, Paris, France; wINSERM, UMR S953, Epidemiological Research Unit on Perinatal Health and Women's and Childrens' Health, Paris, France; xDepartment of Preventive Medicine and Public Health, Univ
出版信息
Epidemiology. 2014 Sep;25(5):636-47. doi: 10.1097/EDE.0000000000000133.
BACKGROUND
Accumulating evidence from laboratory animal and human studies suggests that air pollution exposure during pregnancy affects cognitive and psychomotor development in childhood.
METHODS
We analyzed data from 6 European population-based birth cohorts-GENERATION R (The Netherlands), DUISBURG (Germany), EDEN (France), GASPII (Italy), RHEA (Greece), and INMA (Spain)-that recruited mother-infant pairs from 1997 to 2008. Air pollution levels-nitrogen oxides (NO2, NOx) in all regions and particulate matter (PM) with diameters of <2.5, <10, and 2.5-10 μm (PM2.5, PM10, and PMcoarse, respectively) and PM2.5 absorbance in a subgroup-at birth addresses were estimated by land-use regression models, based on monitoring campaigns performed primarily between 2008 and 2011. Levels were back-extrapolated to exact pregnancy periods using background monitoring sites. Cognitive and psychomotor development was assessed between 1 and 6 years of age. Adjusted region-specific effect estimates were combined using random-effects meta-analysis.
RESULTS
A total of 9482 children were included. Air pollution exposure during pregnancy, particularly NO2, was associated with reduced psychomotor development (global psychomotor development score decreased by 0.68 points [95% confidence interval = -1.25 to -0.11] per increase of 10 μg/m in NO2). Similar trends were observed in most regions. No associations were found between any air pollutant and cognitive development.
CONCLUSIONS
Air pollution exposure during pregnancy, particularly NO2 (for which motorized traffic is a major source), was associated with delayed psychomotor development during childhood. Due to the widespread nature of air pollution exposure, the public health impact of the small changes observed at an individual level could be considerable.
背景
来自实验动物和人类研究的越来越多的证据表明，孕期暴露于空气污染中会影响儿童的认知和心理运动发育。
方法
我们分析了来自6个欧洲基于人群的出生队列——R代研究（荷兰）、杜伊斯堡研究（德国）、伊登研究（法国）、加施皮研究（意大利）、瑞亚研究（希腊）和INMA研究（西班牙）的数据，这些研究在1997年至2008年招募了母婴对。空气污染水平——所有地区的氮氧化物（二氧化氮、氮氧化物）以及直径<2.5、<10和2.5 - 10μm的颗粒物（分别为细颗粒物、可吸入颗粒物和粗颗粒物）以及一个亚组中的细颗粒物吸光度——在出生地址通过土地利用回归模型进行估计，该模型基于主要在2008年至2011年期间开展的监测活动。利用背景监测站点将这些水平反向推算至精确的孕期。在1至6岁之间评估认知和心理运动发育情况。使用随机效应荟萃分析合并调整后的特定区域效应估计值。
结果
共纳入9482名儿童。孕期暴露于空气污染，尤其是二氧化氮，与心理运动发育迟缓有关（二氧化氮每增加10μg/m，全球心理运动发育得分降低0.68分[95%置信区间 = -1.25至 -0.11]）。在大多数地区观察到类似趋势。未发现任何空气污染物与认知发育之间存在关联。
结论
孕期暴露于空气污染，尤其是二氧化氮（机动车交通是其主要来源），与儿童期心理运动发育延迟有关。由于空气污染暴露的普遍性，在个体层面观察到的微小变化对公众健康的影响可能相当大。
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