Spatial Science Institute, University of Southern California, Los Angeles, CA, USA.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Environ Res. 2022 May 15;208:112590. doi: 10.1016/j.envres.2021.112590. Epub 2021 Dec 17.
Many studies have found associations between early life air pollution exposure and subsequent onset of autism spectrum disorder (ASD). However, characteristics that affect susceptibility remain unclear.
This systematic review examined epidemiologic studies on the modifying roles of social, child, genetic and maternal characteristics in associations between prenatal and early postnatal air pollution exposure and ASD.
A systematic literature search in PubMed and Embase was conducted. Studies that examined modifiers of the association between air pollution and ASD were included.
A total of 19 publications examined modifiers of the associations between early life air pollution exposures and ASD. In general, estimates of effects on risk of ASD in boys were larger than in girls (based on 11 studies). Results from studies of effects of family education (2 studies) and neighborhood deprivation (2 studies) on air pollution-ASD associations were inconsistent. Limited data (1 study) suggest pregnant women with insufficient folic acid intake might be more susceptible to ambient particulate matter less than 2.5 μm (PM) and 10 μm (PM) in aerodynamic diameter, and to nitrogen dioxide (NO). Children of mothers with gestational diabetes had increased risk of ozone-associated ASD (1 study). Two genetic studies reported that copy number variations may amplify the effect of ozone, and MET rs1858830 CC genotype may augment effects of PM and near-roadway pollutants on ASD.
Child's sex, maternal nutrition or diabetes, socioeconomic factors, and child risk genotypes were reported to modify the effect of early-life air pollutants on ASD risk in the epidemiologic literature. However, the sparsity of studies on comparable modifying hypotheses precludes conclusive findings. Further research is needed to identify susceptible populations and potential targets for preventive intervention.
许多研究发现，早期生活中的空气污染暴露与随后自闭症谱系障碍（ASD）的发生之间存在关联。然而，影响易感性的特征尚不清楚。
本系统评价研究了社会、儿童、遗传和母体特征在产前和产后早期空气污染暴露与 ASD 之间关联中的调节作用。
在 PubMed 和 Embase 中进行了系统文献检索。纳入了研究空气污染与 ASD 之间关联的调节因素的研究。
共有 19 篇文献研究了早期生活空气污染暴露与 ASD 之间关联的调节因素。一般来说，男孩的 ASD 风险增加的估计值大于女孩（基于 11 项研究）。关于家庭教育（2 项研究）和邻里贫困（2 项研究）对空气污染-ASD 关联影响的研究结果不一致。有限的数据（1 项研究）表明，叶酸摄入不足的孕妇可能更容易受到空气动力学直径小于 2.5μm（PM）和 10μm（PM）的环境颗粒物以及二氧化氮（NO）的影响。患有妊娠期糖尿病的母亲的孩子患臭氧相关 ASD 的风险增加（1 项研究）。两项遗传研究报告称，拷贝数变异可能放大臭氧的影响，MET rs1858830 CC 基因型可能放大 PM 和近路污染物对 ASD 的影响。
在流行病学文献中，有报道称儿童的性别、母亲的营养或糖尿病、社会经济因素以及儿童的风险基因型可调节早期生活空气污染物对 ASD 风险的影响。然而，关于可比调节假设的研究稀疏，无法得出结论性的发现。需要进一步的研究来确定易感人群和潜在的预防干预目标。
