Impact of household air pollution (HAP) in-utero through early childhood on neurocognitive development from infancy to 8 years (HAPCOG Study)

童年时期宫内家庭空气污染 (HAP) 对婴儿期至 8 岁神经认知发展的影响（HAPCOG 研究）

• 批准号: 10206143
• 负责人: CHRISTOPHER O OLOPADE
• 金额: $ 61.69万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10206143
• 关键词: 4 year old; 8 year old; Affect; Africa South of the Sahara; Age; Air; Air Pollution; Alcohol consumption; Biological Markers; Biomass; Blood; Brain; Carbon Black; Cardiovascular system; Cessation of life; Child; Chronic; Cognitive; Communities; Cookstove; Deposition; Development; Enrollment; Ethanol; Exposure to; Fetal Development; Fetal Growth Retardation; Future; Gases; Gestational Age; Goals; Grain; Growth; Health; Health Policy; Heavy Metals; Histologic; Home; Home environment; Household; Household Air Pollution; Hypertension; Hypoxia; Impairment; Infant; Inflammation; Inflammatory; Inhalation; Kerosene; Language; Lead; Low Birth Weight Infant; Mediating; Micronutrients; Modeling; Monitor; Mothers; Motor; Nervous System Physiology; Nervous System Trauma; Neurocognition; Neurocognitive; Neurocognitive Deficit; Neurologic; Newborn Infant; Nigeria; Nigerian; Nutritional status; Outcome; Oxidative Stress; Oxygen; Particulate Matter; Performance; Personal Satisfaction; Placenta; Policies; Pregnancy; Pregnancy Outcome; Pregnancy Trimesters; Pregnant Women; Premature Birth; Psychosocial Stress; Public Health; Questionnaires; Randomized; Randomized Controlled Trials; Reporting; Research; Risk; Risk Factors; Sampling; Second Pregnancy Trimester; Spontaneous abortion; Stress; System; Testing; Third Pregnancy Trimester; Translating; Validation; Variant; Vascularization; Woman; Work; adverse pregnancy outcome; attributable mortality; base; biomass fuel; brain tissue; cardiovascular injury; cohort; cooking; cytokine; deprivation; early childhood; executive function; fine particles; in utero; infancy; low and middle-income countries; maternal stress; pollutant; postnatal; pregnant; prenatal; programs; psychosocial; respiratory; systemic inflammatory response

ABSTRACT Around the world, 93% of children under age 15 breathe toxic air every day that puts their health and development at risk. Of 7 million deaths per year attributable to air pollution, over 60% are due to exposure to household air pollution (HAP) from burning biomass fuels or kerosene for household energy needs. Such fuels burn inefficiently, producing toxic pollutants like fine particulate matter (PM2.5) and black carbon (BC). Mothers and children suffer the highest exposures, resulting in respiratory, cardiovascular, and neurologic injury. Risks to children begin in-utero. Pregnant women inhale polluted air, with ill effects on their developing fetuses and newborns, including growth restriction, preterm birth, and low birth weight. Mounting evidence suggests that HAP can impair infant and child neurocognitive development. Particulate matter deposits in brain tissue have been demonstrated; also, HAP is a medium of exposure to heavy metals. High exposures likely induce oxidative stress and systemic inflammation. There is evidence of mediating factors: maternal stress level, mother/child nutritional status, and home environment. We will explore the impact of HAP exposures on child neurocognitive development, assessing the influence of known mediating factors. Our research capitalizes on a unique opportunity flowing from a recent randomized controlled trial (RCT) in Nigeria. We randomized 324 pregnant women into groups based on fuel use: clean versus polluting. Polluting-fuel users showed: 1) increased preterm delivery, miscarriage, and reduced gestational age at delivery, 2) biomarkers of placental oxygen deprivation, 3) excessive placental vascularization, and 4) increased systemic inflammation. We further found that polluting-fuel users reported more psychosocial stress and less energy during pregnancy. We have continued to follow the RCT children (DISCOVERY COHORT), monitoring their HAP exposures. We propose now to test the hypothesis that high pre- and postnatal HAP exposure negatively impacts neurocognitive development. We will assess development in our DISCOVERY COHORT and an added VALIDATION COHORT of newborns from a new group of pregnant (3rd trimester) women. We will monitor personal HAP exposures of mothers and children, assessing biomarkers of inflammation and oxidative stress and blood levels of micronutrients and heavy metals. We aim to assess neurocognitive development from infancy to age 8 years as associated with: (1) prenatal and early childhood HAP exposures; (2) maternal psychosocial stress level, maternal and child nutritional status, and child's home environment. Impact: Results will illuminate how HAP exposures and maternal stress affect child neurocognitive development, informing policies to reduce HAP through programs that promote use of clean-fuel cookstoves. We will develop language/culturally-adapted assessments of child neurocognition—much needed in sub-Saharan Africa—and establish pilot performance norms. This will build capacity for more research of this kind in Nigeria in the future.

摘要 在世界各地，93%的15岁以下儿童每天呼吸有毒空气， 发展面临风险。每年有700万人死于空气污染，其中60%以上是由于暴露于 家庭空气污染（HAP）来自燃烧生物质燃料或煤油的家庭能源需求。这种燃料 燃烧效率低，产生有毒污染物，如细颗粒物（PM2.5）和黑碳（BC）。母亲 儿童受到的辐射量最高，导致呼吸系统、心血管和神经系统损伤。风险 开始在子宫内。孕妇吸入受污染的空气，对发育中的胎儿产生不良影响， 新生儿，包括生长受限、早产和低出生体重。越来越多的证据表明， HAP可损害婴儿和儿童的神经认知发育。颗粒物质沉积在脑组织中 已被证明;此外，HAP是暴露于重金属的媒介。高暴露可能导致 氧化应激和全身炎症。有证据表明存在中介因素：母亲的压力水平， 母亲/儿童营养状况和家庭环境。我们将探讨HAP暴露对儿童的影响， 神经认知发育，评估已知中介因素的影响。我们的研究利用了 最近在尼日利亚进行的一项随机对照试验（RCT）提供了一个独特的机会。我们随机分配了324名 根据用途：清洁燃料和污染燃料，将孕妇分为两组。污染燃料用户显示：1） 早产、流产增加，分娩时胎龄减少，2）胎盘标志物 缺氧，3）过度的胎盘血管化，和4）增加的全身炎症。我们进一步 研究发现，污染燃料使用者在怀孕期间报告了更多的心理压力和更少的能量。我们有 继续跟踪RCT儿童（DISCOVERY COHORT），监测他们的HAP暴露。我们现在提议 为了检验产前和产后高HAP暴露对神经认知产生负面影响的假设， 发展我们将评估我们的发现队列和附加验证队列的开发， 新生儿从一个新的一组怀孕（第三个三个月）的妇女。我们将监测个人接触HAP的情况， 母亲和儿童，评估炎症和氧化应激的生物标志物以及血液中 微量元素和重金属。我们的目标是评估从婴儿到8岁的神经认知发展 与：（1）产前和幼儿期HAP暴露;（2）母亲的心理社会压力水平， 母亲和儿童的营养状况，以及儿童的家庭环境。影响：结果将阐明HAP如何 暴露和母亲压力影响儿童神经认知发育，为减少HAP的政策提供信息 通过推广使用清洁燃料炉灶的项目。我们将开发语言/文化适应 评估儿童神经认知--这在撒哈拉以南非洲地区非常需要--并建立试点绩效 规范高效这将为尼日利亚今后开展更多的这类研究建立能力。