Chuang Bao-Ru, Lee Chung-Chin, Lin Yu-Ting, Jung Chau-Ren, Chen Mei-Ling, Hwang Bing-Fang
Department of Occupational Safety and Health, College of Public Health, China Medical University, No. 100, Section 1, Economic and Trade Road, Beitun District, Taichung, 406040, Taiwan, Republic of China.
Department of Biomedical Informatics, College of Medicine, China Medical University, Taichung, Taiwan.
Eur J Epidemiol. 2025 Jan;40(1):71-80. doi: 10.1007/s10654-024-01198-2. Epub 2025 Jan 13.
Although several environmental factors may increase the risk of nervous system anomalies, the association between exposure to particulate matter with an aerodynamic diameter of ≤ 2.5 μm (PM) and nervous system anomalies is not completely understood. This study aimed to examine the association between expoure to PM and nervous system anomalies, including specific phenotypes during preconception and early pregnancy and determine the crucial time windows. We conducted a nested case-control study from the Taiwan Maternal and Child Health Database between 2004 and 2017. We applied satellite-based models with a 1 km resolution to estimate the weekly average PM from 13 weeks before conception to the first 8 weeks of pregnancy. We used conditional logistic regression with distributed lag nonlinear models (DLNMs) to assess the effects of weekly average PM on the risk of nervous system anomalies and exposure-response relationships. We identified 12,383 incident nervous system anomalies cases in 2,571,300 participants. A 10 µg/m³ increase in PM concentrations from a reference value of 25 µg/m³ was associated with higher risk of nervous system anomalies (adjusted odds ratio [aOR]: 1.21; 95% confidence incidence [CI]: 1.18, 1.25) and encephalocele (aOR: 1.56; 95% CI: 1.33, 1.84) from 13 weeks before conception to the first 8 weeks of gestation. Anencephaly showed a significant association with PM exposure during the 13 weeks before conception (aOR: 1.48; 95% CI: 1.02, 2.51). In DLNMs, the risk of nervous system anomalies was elevated each week from 8 to 11 weeks before conception to 1-8 weeks of gestation. Our findings suggest that exposure to PM during preconception and early pregnancy may increase the risk of nervous system anomalies in offspring, particularly neural tube defects such as anencephaly and encephalocele.
尽管多种环境因素可能会增加神经系统异常的风险，但空气动力学直径≤2.5μm的颗粒物（PM）暴露与神经系统异常之间的关联尚未完全明确。本研究旨在探讨PM暴露与神经系统异常之间的关联，包括孕前和孕早期的特定表型，并确定关键的时间窗。我们在2004年至2017年期间从台湾妇幼健康数据库中开展了一项巢式病例对照研究。我们应用分辨率为1千米的基于卫星的模型来估算从受孕前13周到妊娠前8周的每周平均PM。我们使用条件逻辑回归和分布滞后非线性模型（DLNMs）来评估每周平均PM对神经系统异常风险和暴露-反应关系的影响。我们在2571300名参与者中识别出12383例新发神经系统异常病例。从25μg/m³的参考值起，PM浓度每增加10μg/m³，与受孕前13周到妊娠前8周期间神经系统异常（调整优势比[aOR]：1.21；95%置信区间[CI]：1.18，1.25）和脑膨出（aOR：1.56；95%CI：1.33，1.84）的风险升高相关。无脑儿在受孕前13周期间与PM暴露存在显著关联（aOR：1.48；95%CI：1.02，2.51）。在DLNMs中，受孕前8至11周以及妊娠1至8周期间，每周神经系统异常的风险均升高。我们的研究结果表明，孕前和孕早期暴露于PM可能会增加后代神经系统异常的风险，尤其是神经管缺陷，如无脑儿和脑膨出。
