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; Department of Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, USA.
Environ Int. 2023 Sep;179:108148. doi: 10.1016/j.envint.2023.108148. Epub 2023 Aug 14.
Autism Spectrum Disorder (ASD) risk is highly heritable, with potential additional non-genetic factors, such as prenatal exposure to ambient particulate matter with aerodynamic diameter < 2.5 µm (PM) and maternal immune activation (MIA) conditions. Because these exposures may share common biological effect pathways, we hypothesized that synergistic associations of prenatal air pollution and MIA-related conditions would increase ASD risk in children.
This study examined interactions between MIA-related conditions and prenatal PM or major PM components on ASD risk.
In a population-based pregnancy cohort of children born between 2001 and 2014 in Southern California, 318,751 mother-child pairs were followed through electronic medical records (EMR); 4,559 children were diagnosed with ASD before age 5. Four broad categories of MIA-related conditions were classified, including infection, hypertension, maternal asthma, and autoimmune conditions. Average exposures to PM and four PM components, black carbon (BC), organic matter (OM), nitrate (NO), and sulfate (SO), were estimated at maternal residential addresses during pregnancy. We estimated the ASD risk associated with MIA-related conditions, air pollution, and their interactions, using Cox regression models to adjust for covariates.
ASD risk was associated with MIA-related conditions [infection (hazard ratio 1.11; 95% confidence interval 1.05-1.18), hypertension (1.30; 1.19-1.42), maternal asthma (1.22; 1.08-1.38), autoimmune disease (1.19; 1.09-1.30)], with higher pregnancy PM [1.07; 1.03-1.12 per interquartile (3.73 μg/m) increase] and with all four PM components. However, there were no interactions of each category of MIA-related conditions with PM or its components on either multiplicative or additive scales.
MIA-related conditions and pregnancy PM were independently associations with ASD risk. There were no statistically significant interactions of MIA conditions and prenatal PM exposure with ASD risk.
自闭症谱系障碍（ASD）的风险具有高度遗传性，可能存在其他非遗传因素，例如产前暴露于空气动力学直径<2.5µm 的环境颗粒物（PM）和母体免疫激活（MIA）条件。由于这些暴露可能具有共同的生物学效应途径，我们假设产前空气污染和与 MIA 相关的条件的协同关联会增加儿童患 ASD 的风险。
本研究探讨了 MIA 相关条件与产前 PM 或主要 PM 成分对 ASD 风险的相互作用。
在加利福尼亚南部 2001 年至 2014 年期间出生的一项基于人群的妊娠队列中，通过电子病历（EMR）对 318751 对母婴进行了随访；4559 名儿童在 5 岁之前被诊断出患有 ASD。将 MIA 相关条件分为四大类，包括感染、高血压、母体哮喘和自身免疫性疾病。在妊娠期间，估计了母体居住地址的 PM 及四种 PM 成分（黑碳（BC）、有机物（OM）、硝酸盐（NO）和硫酸盐（SO））的平均暴露量。我们使用 Cox 回归模型调整协变量，估计与 MIA 相关的条件、空气污染及其相互作用与 ASD 风险的关联。
ASD 风险与 MIA 相关条件相关[感染（危险比 1.11；95%置信区间 1.05-1.18）、高血压（1.30；1.19-1.42）、母体哮喘（1.22；1.08-1.38）、自身免疫性疾病（1.19；1.09-1.30）]，随着妊娠 PM 水平的升高[每增加一个四分位距（3.73μg/m），风险比为 1.07；1.03-1.12]和所有四种 PM 成分的风险比也随之升高。然而，在乘法或加法尺度上，MIA 相关条件的每个类别与 PM 或其成分之间均没有交互作用。
MIA 相关条件和妊娠 PM 与 ASD 风险独立相关。MIA 条件和产前 PM 暴露与 ASD 风险之间没有统计学意义的相互作用。
