Enkhbat Undarmaa, Gombojav Enkhjargal, Banzrai Chimeglkham, Batsukh Sarangerel, Boldbaatar Buyantushig, Enkhtuya Enkhtuul, Bellinger David C, Lanphear Bruce P, McCandless Lawrence C, Allen Ryan W
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada; School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
Environ Int. 2022 Oct;168:107432. doi: 10.1016/j.envint.2022.107432. Epub 2022 Jul 25.
Developmental exposure to airborne particulate matter (PM) may increase children's risk of developing autism spectrum disorder. We quantified the impact of reducing PM exposure during pregnancy on the development of autistic traits in children. We also assessed associations between indoor fine PM (PM) concentrations during pregnancy and autistic traits.
In this parallel-group randomized controlled trial, we randomized 540 non-smoking pregnant women to receive HEPA filter air cleaners or to a control group, which did not receive air cleaners. We administered the Social Responsiveness Scale (SRS-2) to caregivers when children were a median of 48 months (range: 48 to 51 months). Our primary outcome was the SRS-2 total T-score. We imputed missing data using multiple imputation with chained equations and our primary analysis was by intention to treat. In secondary analyses, we estimated associations between full pregnancy and trimester-specific indoor PM concentrations and T-scores.
We enrolled participants at a median of 11 weeks' gestation. Our analysis included 478 children (233 control, 245 intervention). The intervention reduced average indoor PM concentrations by 29 % (95 % CI: 21, 37 %). The mean SRS-2 total T-score was 0.5 units lower (95 % CI: -2.5, 1.5) among intervention participants, with evidence of larger benefits for children at the high end of the T-score distribution. An interquartile range (9.6 µg/m) increase in indoor PM during pregnancy was associated with 1.8-unit (95 % CI: 0.3, 3.2) increase in mean SRS-2 total T-score. Effect estimates for PM concentrations by trimester were smaller and confidence intervals spanned no effect.
Reducing indoor PM during pregnancy had little impact on mean autism-related behavior scores in children. However, indoor PM concentrations during pregnancy were associated with higher scores. Exposure to particulate matter during pregnancy may influence the development of autistic traits in childhood.
ClinicalTrials.gov: NCT01741051.
孕期暴露于空气中的颗粒物（PM）可能会增加儿童患自闭症谱系障碍的风险。我们量化了孕期减少PM暴露对儿童自闭症特征发展的影响。我们还评估了孕期室内细颗粒物（PM）浓度与自闭症特征之间的关联。
在这项平行组随机对照试验中，我们将540名不吸烟的孕妇随机分为两组，一组接受高效空气过滤器空气净化器，另一组作为对照组，不接受空气净化器。当儿童年龄中位数为48个月（范围：48至51个月）时，我们向其照顾者发放社会反应量表（SRS-2）。我们的主要结局是SRS-2总T分数。我们使用链式方程多重填补法填补缺失数据，主要分析采用意向性分析。在次要分析中，我们估计了整个孕期和各孕期特定的室内PM浓度与T分数之间的关联。
我们在妊娠中位数为11周时招募了参与者。我们的分析纳入了共478名儿童（233名对照组，245名干预组）。干预措施使室内平均PM浓度降低了29%（95%CI：21，37%）。干预组参与者的SRS-2总T分数平均低0.5分（95%CI：-2.5，1.5），有证据表明对于T分数分布高端的儿童有更大益处。孕期室内PM每增加一个四分位数间距（9.6µg/m），SRS-2总T分数平均增加1.8分（95%CI：0.3，3.2）。按孕期划分的PM浓度效应估计值较小，置信区间包含无效应。
孕期减少室内PM对儿童自闭症相关行为平均得分影响不大。然而，孕期室内PM浓度与更高得分相关。孕期暴露于颗粒物可能会影响儿童期自闭症特征的发展。
ClinicalTrials.gov：NCT01741051。
