Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Environ Int. 2022 Jan;158:106898. doi: 10.1016/j.envint.2021.106898. Epub 2021 Oct 6.
Previous studies have reported associations between in utero exposure to regional air pollution and autism spectrum disorders (ASD). In utero exposure to components of near-roadway air pollution (NRAP) has been linked to adverse neurodevelopment in animal models, but few studies have investigated NRAP association with ASD risk.
To identify ASD risk associated with in utero exposure to NRAP in a large, representative birth cohort.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective pregnancy cohort study included 314,391 mother-child pairs of singletons born between 2001 and 2014 at Kaiser Permanente Southern California (KPSC) hospitals. Maternal and child data were extracted from KPSC electronic medical records. Children were followed until: clinical diagnosis of ASD, non-KPSC membership, death, or December 31, 2019, whichever came first. Exposure to the complex NRAP mixture during pregnancy was assessed using line-source dispersion models to estimate fresh vehicle emissions from freeway and non-freeway sources at maternal addresses during pregnancy. Vehicular traffic load exposure was characterized using advanced telematic models combining traditional traffic counts and travel-demand models with cell phone and vehicle GPS data. Cox proportional-hazard models estimated hazard ratios (HR) of ASD associated with near-roadway traffic load and dispersion-modeled NRAP during pregnancy, adjusted for covariates. Non-freeway NRAP was analyzed using quintile distribution due to nonlinear associations with ASD.
Average NRAP and traffic load exposure during pregnancy at maternal residential addresses.
Clinical diagnosis of ASD.
A total of 6,291 children (5,114 boys, 1,177 girls) were diagnosed with ASD. The risk of ASD was associated with pregnancy-average exposure to total NRAP [HR(95% CI): 1.03(1.00,1.05) per 5 ppb increase in dispersion-modeled NOx] and to non-freeway NRAP [HR(95% CI) comparing the highest to the lowest quintile: 1.19(1.11, 1.27)]. Total NRAP had a stronger association in boys than in girls, but the association with non-freeway NRAP did not differ by sex. The association of freeway NRAP with ASD risk was not statistically significant. Non-freeway traffic load exposure demonstrated associations with ASD consistent with those of NRAP and ASD.
In utero exposure to near-roadway air pollution, particularly from non-freeway sources, may increase ASD risk in children.
先前的研究报告了宫内暴露于区域空气污染与自闭症谱系障碍（ASD）之间的关联。动物模型中，与近路（NRAP）空气污染有关的宫内暴露与神经发育不良有关，但很少有研究调查 NRAP 与 ASD 风险的关联。
在一个大型的、有代表性的出生队列中，确定与 NRAP 宫内暴露相关的 ASD 风险。
设计、地点和参与者：这是一项回顾性妊娠队列研究，纳入了 2001 年至 2014 年期间在 Kaiser Permanente Southern California（KPSC）医院出生的 314391 对单胎母婴。从 KPSC 电子病历中提取母婴数据。对儿童进行随访，直到：ASD 的临床诊断、非 KPSC 会员、死亡或 2019 年 12 月 31 日，以先到者为准。使用线源扩散模型评估怀孕期间复杂的 NRAP 混合物暴露情况，以估计怀孕期间母体地址处来自高速公路和非高速公路源的新鲜车辆排放。利用结合传统交通计数和出行需求模型与手机和车辆 GPS 数据的先进远程信息处理模型，对车辆交通负荷暴露情况进行了描述。由于非高速公路 NRAP 与 ASD 之间存在非线性关联，因此使用五分位数分布进行了分析。
怀孕期间母体居住地址的平均 NRAP 和交通负荷暴露。
临床诊断为 ASD。
共有 6291 名儿童（5114 名男孩，1177 名女孩）被诊断为 ASD。ASD 风险与怀孕期间平均暴露于总 NRAP[风险比（95%置信区间）：每增加 5ppb 扩散模型 NOx 增加 1.03（1.00，1.05）]和非高速公路 NRAP[比较最高和最低五分位数的 HR（95%CI）：1.19（1.11，1.27）]相关。总 NRAP 与男孩的关联比女孩更强，但与非高速公路 NRAP 的关联不因性别而异。高速公路 NRAP 与 ASD 风险的关联无统计学意义。非高速公路交通负荷暴露与 ASD 风险的关联与 NRAP 和 ASD 一致。
宫内暴露于近路空气污染，特别是来自非高速公路的空气污染，可能会增加儿童患 ASD 的风险。
