Zhuo Haoran, Ritz Beate, Warren Joshua L, Pollitt Krystal Godri, Liew Zeyan
Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.
Environ Health Perspect. 2025 Jan;133(1):17008. doi: 10.1289/EHP14742. Epub 2025 Jan 24.
Cerebral palsy (CP) is the most common permanent neuromotor disorder diagnosed in childhood. Although most cases have unknown etiology, emerging evidence suggests environmental risk factors of CP.
We investigated whether ambient toxic air contaminants (TACs) in the maternal residential area during pregnancy, specifically volatile organic compounds (VOCs) and metals, were associated with offspring CP risk in California.
We conducted a case-cohort study that included CP cases () and a 20% random sample of all live singleton births () who lived within a (8-km) radius of air toxics monitoring stations in California during 2005-2015 as the control comparison group. CP cases were ascertained from diagnostic records of the California Department of Developmental Services. We selected TACs with suspected neurotoxicity and developmental toxicity, including 14 VOCs and 6 metals. We estimated the adjusted risk ratio (RR) and 95% confidence interval (CI) for CP and the average maternal residential exposures to each TAC over the entire pregnancy using modified Poisson regression. For air contaminant mixtures, we used quantile-based g-computation to estimate the effects of mixtures of VOCs or metals. Finally, we performed a negative control exposure analysis on exposure estimates of 36-48 months after delivery to evaluate uncontrolled confounding bias.
Maternal residential exposures to six VOCs (benzene, toluene, 1,3-butadiene, acetone, acetonitrile, and methylene chloride) and four metals (antimony, lead, nickel, and vanadium) were associated with 3%-25% higher risk of CP per interquartile range increase, and the estimated mixture effects of VOCs (; 95% CI: 1.08, 1.43) or metals (; 95% CI: 1.20, 1.58) were stronger. The observed associations were close to null for negative control exposures (36-48 months after delivery) to mixtures of VOCs or metals and CP.
In California, maternal prenatal residential exposure to VOCs and metals in the outdoor air, largely attributed to mobile traffic emission sources, was associated with an increased risk of CP in offspring. https://doi.org/10.1289/EHP14742.
脑瘫（CP）是儿童期诊断出的最常见的永久性神经运动障碍。尽管大多数病例病因不明，但新出现的证据表明存在脑瘫的环境风险因素。
我们调查了孕期母亲居住地区的环境有毒空气污染物（TACs），特别是挥发性有机化合物（VOCs）和金属，是否与加利福尼亚州后代患脑瘫的风险相关。
我们进行了一项病例队列研究，其中包括脑瘫病例（）以及2005年至2015年期间居住在加利福尼亚州空气毒物监测站半径（8公里）范围内的所有单胎活产婴儿的20%随机样本作为对照比较组。脑瘫病例通过加利福尼亚州发展服务部的诊断记录确定。我们选择了具有疑似神经毒性和发育毒性的有毒空气污染物，包括14种挥发性有机化合物和6种金属。我们使用修正的泊松回归估计脑瘫的调整风险比（RR）和95%置信区间（CI），以及整个孕期母亲居住地区每种有毒空气污染物的平均暴露量。对于空气污染物混合物，我们使用基于分位数的g计算来估计挥发性有机化合物或金属混合物的影响。最后，我们对分娩后36至48个月的暴露估计值进行了阴性对照暴露分析，以评估未控制的混杂偏倚。
母亲居住地区暴露于六种挥发性有机化合物（苯、甲苯、1,3 - 丁二烯、丙酮、乙腈和二氯甲烷）和四种金属（锑、铅、镍和钒），每四分位数间距增加，患脑瘫的风险就会增加3% - 25%，并且挥发性有机化合物（；95% CI：1.08，1.43）或金属（；95% CI：1.20，1.58）的估计混合物效应更强。对于分娩后36至48个月对挥发性有机化合物或金属混合物与脑瘫的阴性对照暴露，观察到的关联接近零。
在加利福尼亚州，母亲产前居住地区暴露于室外空气中的挥发性有机化合物和金属，主要归因于移动交通排放源，与后代患脑瘫的风险增加有关。https://doi.org/10.1289/EHP14742。
