Raz Raanan, Roberts Andrea L, Lyall Kristen, Hart Jaime E, Just Allan C, Laden Francine, Weisskopf Marc G
Department of Environmental Health, Department of Social and Behavioral Sciences, and Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Environ Health Perspect. 2015 Mar;123(3):264-70. doi: 10.1289/ehp.1408133. Epub 2014 Dec 18.
Autism spectrum disorder (ASD) is a developmental disorder with increasing prevalence worldwide, yet has unclear etiology.
We explored the association between maternal exposure to particulate matter (PM) air pollution and odds of ASD in her child.
We conducted a nested case-control study of participants in the Nurses' Health Study II (NHS II), a prospective cohort of 116,430 U.S. female nurses recruited in 1989, followed by biennial mailed questionnaires. Subjects were NHS II participants' children born 1990-2002 with ASD (n = 245), and children without ASD (n = 1,522) randomly selected using frequency matching for birth years. Diagnosis of ASD was based on maternal report, which was validated against the Autism Diagnostic Interview-Revised in a subset. Monthly averages of PM with diameters ≤ 2.5 μm (PM2.5) and 2.5-10 μm (PM10-2.5) were predicted from a spatiotemporal model for the continental United States and linked to residential addresses.
PM2.5 exposure during pregnancy was associated with increased odds of ASD, with an adjusted odds ratio (OR) for ASD per interquartile range (IQR) higher PM2.5 (4.42 μg/m3) of 1.57 (95% CI: 1.22, 2.03) among women with the same address before and after pregnancy (160 cases, 986 controls). Associations with PM2.5 exposure 9 months before or after the pregnancy were weaker in independent models and null when all three time periods were included, whereas the association with the 9 months of pregnancy remained (OR = 1.63; 95% CI: 1.08, 2.47). The association between ASD and PM2.5 was stronger for exposure during the third trimester (OR = 1.42 per IQR increase in PM2.5; 95% CI: 1.09, 1.86) than during the first two trimesters (ORs = 1.06 and 1.00) when mutually adjusted. There was little association between PM10-2.5 and ASD.
Higher maternal exposure to PM2.5 during pregnancy, particularly the third trimester, was associated with greater odds of a child having ASD.
自闭症谱系障碍（ASD）是一种发育障碍，在全球范围内患病率不断上升，但其病因尚不清楚。
我们探讨了母亲暴露于颗粒物（PM）空气污染与孩子患ASD几率之间的关联。
我们对护士健康研究II（NHS II）的参与者进行了一项巢式病例对照研究。NHS II是一项前瞻性队列研究，于1989年招募了116,430名美国女性护士，随后每两年邮寄一次调查问卷。研究对象为1990 - 2002年出生的NHS II参与者的孩子，其中患ASD的孩子（n = 245），以及通过出生年份频率匹配随机选取的未患ASD的孩子（n = 1,522）。ASD的诊断基于母亲的报告，并在一个子集中通过《自闭症诊断访谈修订版》进行了验证。利用美国大陆的时空模型预测直径≤2.5μm（PM2.5）和2.5 - 10μm（PM10 - 2.5）颗粒物的月平均浓度，并将其与居住地址相关联。
孕期暴露于PM2.5与ASD几率增加相关，在孕期前后居住地址相同的女性中（160例病例，986例对照），每四分位间距（IQR）较高的PM2.5（4.42μg/m³）导致ASD的调整优势比（OR）为1.57（95%CI：1.22，2.03）。在独立模型中，孕期前9个月或后9个月与PM2.5暴露的关联较弱，当纳入所有三个时间段时则无关联，而与孕期9个月的关联仍然存在（OR = 1.63；95%CI：1.08，2.47）。相互调整后，与孕晚期PM2.5暴露（每IQR增加PM2.5，OR = 1.42；95%CI：1.09，1.86）相比，孕早期前两个月与ASD的关联（OR分别为1.06和1.00）较弱。PM10 - 2.5与ASD之间几乎没有关联。
孕期母亲尤其是孕晚期较高的PM2.5暴露与孩子患ASD的几率增加有关。
