Differences in exposure assignment between conception and delivery: the impact of maternal mobility
Differences in exposure assignment between conception and delivery: the impact of maternal mobility
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DOI：
10.1111/j.1365-3016.2010.01096.x
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发表时间：
2010-03-01
影响因子：
2.8
通讯作者：
Langlois, Peter H.
中科院分区：
文献类型：
--
作者：
Lupo, Philip J.;Symanski, Elaine;Langlois, Peter H.
P>Lupo PJ、Symanski E、Chan W、Mitchell LE、Waller DK、Canfield MA、Langlois PH。受孕和分娩之间暴露分配的差异：产妇流动性的影响。儿科和围产期流行病学2010； 24：200-208。在生殖结果的研究中，分娩时产妇居住地往往是描述怀孕期间环境暴露特征的唯一可用信息。本次调查的目的是描述怀孕期间的居住流动性，并评估当暴露基于分娩时的地址时，居住地改变可能导致暴露错误分类的程度。对神经管缺陷病例和德克萨斯州国家出生缺陷预防研究 (NBDPS) 参与者的未受影响对照的产妇居住流动性进行了比较。产妇居住信息是从 NBDPS 访谈中获得的。美国 EPA 国家空气毒性评估 [全国人口暴露评估系统 (ASPEN)] 的数据以人口普查区水平为模型，用于根据受孕地址和分娩地址估计苯暴露情况。根据这些估计值分配暴露的四分位数，并使用传统方法（kappa 统计）和混合效应序数逻辑回归的新应用比较基于受孕地址和分娩地址的四分位数分配。总体而言，30% 的病例母亲和 24% 的对照母亲在怀孕期间搬家。病例和对照之间母亲居住流动性的差异并不显着，只是病例母亲在怀孕期间比对照母亲更早搬家（P = 0.01）。两个地址的苯暴露估计四分位数之间有很好的一致性（kappa = 0.78，P < 0.0001）。根据混合效应回归模型，根据 ASPEN 的估计分配苯暴露四分位时，分娩时的地址与使用受孕时的地址没有显着差异（比值比 1.03，95% 置信区间 0.85、1.25）。我们的结果表明，在德克萨斯州人口中，产妇居住移动通常在短距离内，病例和对照之间通常没有差异，并且不会显着影响苯暴露评估。
P>Lupo PJ, Symanski E, Chan W, Mitchell LE, Waller DK, Canfield MA, Langlois PH. Differences in exposure assignment between conception and delivery: the impact of maternal mobility. Paediatric and Perinatal Epidemiology 2010; 24: 200-208.In studies of reproductive outcomes, maternal residence at delivery is often the only information available to characterise environmental exposures during pregnancy. The goal of this investigation was to describe residential mobility during pregnancy and to assess the extent to which change of residence may result in exposure misclassification when exposure is based on the address at delivery.Maternal residential mobility was compared between neural tube defect cases and unaffected controls from Texas participants in the National Birth Defects Prevention Study (NBDPS). Maternal residential information was obtained from the NBDPS interview. Data from the U.S. EPA National Air Toxics Assessment [Assessment System for Population Exposure Nationwide (ASPEN)], modelled at the census tract level, were used to estimate benzene exposure based on address at conception and address at delivery. Quartiles of exposure were assigned based on these estimates and the quartile assignments based on address at conception and address at delivery were compared using traditional methods (kappa statistics) and a novel application of mixed-effects ordinal logistic regression.Overall, 30% of case mothers and 24% of control mothers moved during pregnancy. Differences in maternal residential mobility were not significant between cases and controls, other than case mothers who moved did so earlier during pregnancy than control mothers (P = 0.01). There was good agreement between quartiles of estimated benzene exposure at both addresses (kappa = 0.78, P < 0.0001). Based on the mixed-effects regression model, address at delivery was not significantly different from using address at conception when assigning quartile of benzene exposure based on estimates from ASPEN (odds ratio 1.03, 95% confidence interval 0.85, 1.25). Our results indicate that, in this Texas population, maternal residential movement is generally within short distances, is typically not different between cases and controls, and does not significantly influence benzene exposure assessment.