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Prenatal Exposure to Ambient Air Pollution and Cerebral Palsy.
- Source :
-
JAMA network open [JAMA Netw Open] 2024 Jul 01; Vol. 7 (7), pp. e2420717. Date of Electronic Publication: 2024 Jul 01. - Publication Year :
- 2024
-
Abstract
- Importance: Air pollution is associated with structural brain changes, disruption of neurogenesis, and neurodevelopmental disorders. The association between prenatal exposure to ambient air pollution and risk of cerebral palsy (CP), which is the most common motor disability in childhood, has not been thoroughly investigated.<br />Objective: To evaluate the associations between prenatal residential exposure to ambient air pollution and risk of CP among children born at term gestation in a population cohort in Ontario, Canada.<br />Design, Setting, and Participants: Population-based cohort study in Ontario, Canada using linked, province-wide health administrative databases. Participants were singleton full term births (≥37 gestational weeks) born in Ontario hospitals between April 1, 2002, and March 31, 2017. Data were analyzed from January to December 2022.<br />Exposures: Weekly average concentrations of ambient fine particulate matter with a diameter 2.5 μm (PM2.5) or smaller, nitrogen dioxide (NO2), and ozone (O3) during pregnancy assigned by maternal residence reported at delivery from satellite-based estimates and ground-level monitoring data.<br />Main Outcome and Measures: CP cases were ascertained by a single inpatient hospitalization diagnosis or at least 2 outpatient diagnoses for children from birth to age 18 years.<br />Results: The present study included 1 587 935 mother-child pairs who reached term gestation, among whom 3170 (0.2%) children were diagnosed with CP. The study population had a mean (SD) maternal age of 30.1 (5.6) years and 811 745 infants (51.1%) were male. A per IQR increase (2.7 μg/m3) in prenatal ambient PM2.5 concentration was associated with a cumulative hazard ratio (CHR) of 1.12 (95% CI, 1.03-1.21) for CP. The CHR in male infants (1.14; 95% CI, 1.02-1.26) was higher compared with the CHR in female infants (1.08; 95% CI, 0.96-1.22). No specific window of susceptibility was found for prenatal PM2.5 exposure and CP in the study population. No associations or windows of susceptibility were found for prenatal NO2 or O3 exposure and CP risk.<br />Conclusions and Relevance: In this large cohort study of singleton full term births in Canada, prenatal ambient PM2.5 exposure was associated with an increased risk of CP in offspring. Further studies are needed to explore this association and its potential biological pathways, which could advance the identification of environmental risk factors of CP in early life.
- Subjects :
- Humans
Pregnancy
Female
Male
Ontario epidemiology
Adult
Infant
Child, Preschool
Infant, Newborn
Child
Maternal Exposure adverse effects
Maternal Exposure statistics & numerical data
Cohort Studies
Air Pollutants adverse effects
Air Pollutants analysis
Adolescent
Nitrogen Dioxide adverse effects
Nitrogen Dioxide analysis
Cerebral Palsy epidemiology
Cerebral Palsy etiology
Prenatal Exposure Delayed Effects epidemiology
Air Pollution adverse effects
Air Pollution analysis
Air Pollution statistics & numerical data
Particulate Matter adverse effects
Particulate Matter analysis
Subjects
Details
- Language :
- English
- ISSN :
- 2574-3805
- Volume :
- 7
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- JAMA network open
- Publication Type :
- Academic Journal
- Accession number :
- 38980674
- Full Text :
- https://doi.org/10.1001/jamanetworkopen.2024.20717