Air Pollution and Pregnancy Loss

空气污染与流产

• 批准号: 10404683
• 负责人: Marianthi-Anna Kioumourtzoglou
• 金额: $ 47.55万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-06 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10404683
• 关键词: Address; Adverse effects; Air Pollutants; Air Pollution; Autoimmune Diseases; Biological; Birth; Birth Rate; Birth Records; Body mass index; Boston; Cardiovascular Diseases; Characteristics; Clinical; Conceptions; Coupled; Data; Denmark; Dependence; Distress; Evaluation; Event; Future; Gestational Diabetes; Green space; Grief reaction; Health; High Prevalence; Individual; Intervention; Israel; Lead; Link; Live Birth; Location; Major Depressive Disorder; Medical; Medical Records; Methodology; Methods; Modeling; Modification; Mothers; Neighborhoods; Outcome; Parents; Particulate Matter; Pathway interactions; Policies; Population; Population Database; Population Research; Post-Traumatic Stress Disorders; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy loss; Psychological Impact; Public Health; Publishing; Regulation; Research; Resources; Risk; Risk Factors; Sample Size; Series; Socioeconomic Status; Spontaneous abortion; Statistical Methods; Subgroup; Symptoms; System; Time; United States; Variant; Woman; Work; ambient air pollution; anxiety symptoms; built environment; coarse particles; density; depressive symptoms; deprivation; design; early pregnancy loss; fine particles; innovation; insight; lifestyle factors; medical attention; modifiable risk; novel; novel strategies; particle exposure; predictive modeling; prepregnancy; rural setting; smoking during pregnancy; suburb; traffic-related air pollution; zygote

Project Summary Miscarriage is the most common pregnancy complication in the United States, occurring in 15-20% of all clinically recognized pregnancies. It has devastating impacts on both parents, with elevated anxiety and depressive symptoms in the mother, and even post-traumatic stress disorder, lasting up to a year post-event. Identification of modifiable risk factors of pregnancy loss, thus, is of great public health importance. Ambient air pollution is an increasingly recognizable risk factor for pregnancy complications. Although some evidence exists linking air pollution to pregnancy loss, the need to identify pregnancy loss events through medical records is a large hurdle in comprehensively assessing this association. For the proposed work, we will employ a novel approach that uses the outcome metric of live birth-identified conceptions in a variation of the time series design to overcome this major limitation of all existing studies. To this end, we will use information on all live births recorded in Denmark between 1997 and 2017, and couple these with highly spatio-temporally resolved air pollution predictions from well-validated models. Specifically, we will (1) investigate the association between both particulate matter air pollution exposures, an indicator of the mixture of air pollution, and traffic- related air pollution, a component of ambient air pollution found to be especially toxic for pregnancy complications, and pregnancy loss; (2) identify the critical windows of vulnerability; (3) develop novel methodology to assess potential effect modification by multiple modifiers simultaneously while incorporating the highly resolved time-varying exposures during gestation; and (4) identify maternal- and neighborhood-level effect modifiers, and therefore, the most susceptible subpopulations to air pollution impacts. Our findings can greatly inform targeted regulations and policies, crafting of public health messages, and targeted interventions.

项目概要 流产是美国最常见的妊娠并发症，发生率为 15-20% 临床上认可的妊娠。它对父母双方都有毁灭性的影响，导致焦虑和焦虑加剧 母亲的抑郁症状，甚至创伤后应激障碍，在事件发生后持续长达一年。 因此，识别流产的可改变的危险因素对于公共卫生具有重要意义。环境空气 污染是妊娠并发症的一个日益被认识到的危险因素。虽然有一些证据 空气污染与流产之间存在联系，因此需要通过医疗来识别流产事件 记录是全面评估该协会的一大障碍。对于拟议的工作，我们将雇用 一种新颖的方法，使用不同时间活产识别受孕的结果指标 系列设计克服了所有现有研究的这一主要局限性。为此，我们将使用有关所有信息 1997 年至 2017 年间丹麦记录的活产情况，并将这些与高度时空结合起来 通过经过充分验证的模型解决了空气污染预测问题。具体来说，我们将（1）调查协会 颗粒物空气污染暴露（空气污染混合指标）和交通之间的关系 相关空气污染，环境空气污染的一个组成部分，被发现对怀孕特别有毒 并发症和流产； (2) 识别漏洞的关键窗口； (3)开发新颖 在合并时同时评估多种修饰剂潜在效果修饰的方法 妊娠期间高分辨率的随时间变化的曝光； (4) 确定母亲和社区层面 影响调节剂，因此最容易受到空气污染影响的亚人群。我们的研究结果可以 为有针对性的法规和政策、公共卫生信息的制定和有针对性的干预措施提供大量信息。