Air Pollution and Pregnancy Outcome in New York City

纽约市的空气污染和怀孕结果

• 批准号: 8089013
• 负责人: David A Savitz
• 金额: $ 45.56万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-20 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8089013
• 关键词: Address; Adverse effects; Affect; African American; Air; Air Pollutants; Air Pollution; Area; Birth; Birth Certificates; Birth Records; Calendar; Caliber; Censuses; Cities; Classification; Clinical; Communities; Data; Data Sources; Diagnosis; Education; Ensure; Exposure to; Fetal Development; Fetal Growth; Fetal Growth Retardation; Health; Heating; Hospitals; Hypertension induced by pregnancy; Individual; Infant Mortality; Insurance Coverage; Latina; Level of Evidence; Life; Link; Location; Medical; Mental Health; Modeling; Neighborhoods; New York; New York City; Nitrogen Dioxide; Outcome; Particulate; Particulate Matter; Population; Population Heterogeneity; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Premature Birth; Public Health; Public Policy; Reproductive Health; Research; Resources; Risk; Role; Severities; Small for Gestational Age Infant; Smoking Status; Socioeconomic Status; Source; Subgroup; Surveys; System; Time; Woman; base; design; experience; high risk; indexing; innovation; interest; low socioeconomic status; novel; particle; pollutant; residence; social stress; urban area

DESCRIPTION (provided by applicant): We propose to examine the relationship between air pollution and pregnancy outcome in New York City (NYC) to help determine whether there is a causal link, focusing on the effect of particulate air pollution on preterm birth and reduced fetal growth. There is increasing evidence that levels of particulate air pollution currently experienced in urban areas of the U.S. may have adverse effects on the course and outcome of pregnancy, which would be of great clinical and public health significance. The proposed study will integrate data collected for the New York City Community Air Survey (NYCCAS) with birth records linked to hospital discharge data for approximately 300,000 NYC residents who delivered in calendar years 2007-2009. Based on a rigorously designed survey of 150 locations in NYC, the NYCCAS has developed comprehensive, validated models to estimate levels of ambient fine particulate matter (PM2.5) air pollution and its source constituents, as well as other potentially correlated pollutants throughout the city. Birth records obtained from the NYC Department of Health and Mental Hygiene, including geocoded residence for assigning exposure, will be linked to hospital discharge data for refined classification of the pregnancy outcomes of interest, preterm birth, fetal growth, and pregnancy-induced hypertension, a key determinant. Indicators of socioeconomic status (SES) and other potential confounders are available at the individual level from birth certificates (education, smoking status) and hospital discharge data (insurance coverage), and on an aggregate level for the Census Tract of residence (indices of SES). With this information, we will assess whether PM2.5 and its constituents are related to risk of preterm birth, reduced birthweight, and pregnancy-induced hypertension. With these data resources, we will be able to overcome major limitations of past studies by evaluating the role of particulate constituents and sources, examining subsets of preterm birth based on severity and clinical presentation, and identifying critical time windows during pregnancy when adverse effects are observed. Through these efforts, we will be able to substantially advance our understanding of the hypothesized causal link between air pollution and pregnancy outcome, addressing a question of substantial public health and regulatory importance. PUBLIC HEALTH RELEVANCE: We propose to examine the impact of air pollution on the health of pregnancy in NYC residents, focusing on fetal growth and preterm birth, leading determinants of infant mortality with lifelong health consequences. Resolving the question of whether air pollution harms fetal development is of vital public health and regulatory importance and we have the opportunity to make a substantial contribution to answering that question.

描述（由申请人提供）：我们建议研究纽约市（NYC）空气污染与妊娠结局之间的关系，以帮助确定是否存在因果关系，重点是颗粒空气污染对早产和胎儿生长的影响。越来越多的证据表明，美国目前在美国城市地区经历的颗粒空气污染水平可能会对怀孕的过程和结果产生不利影响，这将具有很大的临床和公共健康意义。拟议的研究将将为纽约市社区空中调查（NYCCA）收集的数据与与医院出院数据有关的出生记录的数据集成，约30万纽约市居民在2007-2009日历年内交付的纽约市居民。基于对纽约市150个地点进行严格设计的调查，NYCCAS开发了全面的，经过验证的模型，以估计环境细颗粒物（PM2.5）空气污染及其源成分以及整个城市中其他潜在相关的污染物的水平。从纽约市卫生和精神卫生部获得的出生记录，包括分配暴露的地理编码住所，将与医院出院数据有关，以精制分类感兴趣的怀孕，早产，胎儿生长，胎儿生长和怀孕诱发的高血压，这是一个关键的决定性。社会经济地位（SES）和其他潜在混杂因素的指标可从出生证明（教育，吸烟状况）和医院出院数据（保险范围）以及居住地的总级别（SES指数）提供。有了这些信息，我们将评估PM2.5及其成分是否与早产的风险，减少出生体重和妊娠诱发的高血压有关。借助这些数据资源，我们将能够通过评估颗粒成分和来源的作用，基于严重程度和临床表现来检查早产子集的作用，并在观察到不良反应时识别怀孕期间的关键时光窗口，从而克服过去研究的主要局限性。通过这些努力，我们将能够实质上提高我们对空气污染与怀孕结果之间假设的因果关系的理解，从而解决了实质性公共卫生和监管重要性的问题。 公共卫生相关性：我们建议研究空气污染对纽约市居民怀孕健康的影响，重点关注胎儿的生长和早产，这是婴儿死亡率的决定因素，并带来终生健康后果。解决空气污染是否损害胎儿发展的问题至关重要，我们有机会为回答该问题做出重大贡献。