Effects to Neonatal Outcomes After In Utero Wildfire Smoke Exposure

子宫内野火烟雾暴露对新生儿结局的影响

• 批准号: 10231964
• 负责人: Tara Marko
• 金额: $ 4.85万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2023-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10231964
• 关键词: Address; Admission activity; Affect; Air; Air Pollution; Apgar Score; Appearance; Area; Autonomic nervous system; Biological Markers; Biometry; Birth; Birth Records; Birth Weight; Blood; Blood Circulation; Care given by nurses; Characteristics; Child; Clinical; Clinical assessments; Collaborations; Confounding Factors (Epidemiology); Country; Data; Data Analyses; Data Sources; Discipline of Nursing; Disease; Environmental Engineering technology; Environmental Exposure; Environmental Health; Epidemiology; Exposure to; Family; Fetus; Financial Hardship; Foundations; Frequencies; Geographic Information Systems; Gestational Age; Growth and Development function; Health; Home; Hormonal; Hospitals; Human; Industrialization; Inflammation; Inhalation; Intensive Care; Knowledge; Laboratories; Life; Link; Low Birth Weight Infant; Lung; Maternal Health; Maternal and Child Health; Measures; Methods; Modeling; Mothers; National Institute of Nursing Research; Neighborhoods; Neonatal; Neonatal Intensive Care; Neonatal Intensive Care Units; Neonatal Nursing; Nurses; Odds Ratio; Outcome; Oxygen; Particulate Matter; Perfusion; Physiologic pulse; Physiological; Placenta; Population; Pregnancy Outcome; Pregnant Women; Premature Birth; Provider; Psychological Stress; Readiness; Research; Respiration; Resuscitation; Retrospective cohort study; Science; Scientist; Seasons; Smoke; Source; Strategic Planning; Stress; Technology; Time; Universities; Variant; Washington; Wildfire; Wood stove; Work; adverse birth outcomes; ambient air pollution; atmospheric sciences; base; career; cost; critical period; experience; fetal; fine particles; in utero; interest; maternal outcome; multidisciplinary; neonatal outcome; neonate; pollutant; population based; prenatal exposure; prevent; rapid growth; research study; secondary analysis; systemic inflammatory response; toxicant; urban area

Abstract Wildfires are a dire and imminent threat to human health. Wildfires are increasing in intensity, duration, and frequency. They are moving beyond wildland borders and into highly populated areas, which means more people are affected. It also means that particulate matter (PM) from wildfire smoke is combined with other pollutants from urban areas and intensifying poor air quality. The mother-fetal dyad is particularly susceptible to toxicants and ambient outdoor air pollution. Evidence has demonstrated that fine PM crosses the blood- placenta barrier and into fetal circulation. To address the critical scientific need for further research of in utero wildfire smoke exposure, we aim to: 1): Analyze the relationship between in utero wildfire smoke exposure and birth outcomes. Hypothesis 1a: There will be a decrease in gestational age at birth after in utero exposure to wildfire smoke. Hypothesis 1b: There will be a decrease in birth weight after in utero exposure to wildfire smoke; 2). Examine the relationship between in utero wildfire smoke exposure and physiological stability and clinical presentation at birth. Hypothesis 2a: There will be a difference in neonatal Apgar scores at 1 minute of life after in utero wildfire smoke exposure. Hypothesis 2b. There will be a difference in Apgar scores at 5 minutes of life after in utero wildfire smoke exposure. 3). Examine the relationship between in utero wildfire smoke exposure and requirements of neonatal intensive care at birth. Hypothesis: There will be an increase in NICU admissions at birth after in utero wildfire smoke exposure. This is a secondary analysis of data available from three sources used to conduct a population-based retrospective cohort study in Washington State. The three data sources include: 1. Air quality data from the Washington State University Laboratory for Atmospheric Research, 2. a Geographic Information System (GIS) that overlays coordinates for longitude and latitude of physical addresses with the air quality data and other spatial characteristics of neighborhoods where mothers resided and 3. maternal health and neonatal birth outcomes data available from the Washington State Department of Health. During the time period of interest (2010 to 2016) there were 611,182 births to mothers with a physical address in WA. For each of the three aims, a generalized linear mixed modeling (GLMM) framework will be used to examine the association between poor birth outcomes and exposure to PM2.5 while controlling for potential confounding variables. A multidisciplinary team with expertise in nursing, air quality, spatial analysis, and biostatistics will support this work. Conducting this research will build on my experience as neonatal intensive care nurse and support a strong foundation in my career as a nurse scientist with a focus on environmental exposure in the maternal child population. This study will build the science to better understand maternal and neonatal outcomes in relation to environmental causes of disease and will inform hospital preparedness for the impacts of increasing and sustained periods of wildfire smoke on maternal and child health.

摘要 野火是对人类健康的可怕和迫在眉睫的威胁。野火的强度、持续时间和 频率.他们正在超越荒地边界，进入人口稠密地区，这意味着更多 人们受到影响。这也意味着野火烟雾中的颗粒物（PM）与其他物质结合在一起， 污染物从城市地区和加剧恶劣的空气质量。母子二体特别容易受到 有毒物质和环境室外空气污染。有证据表明，细颗粒物可以穿过血液- 胎盘屏障并进入胎儿循环。为了满足进一步研究子宫内 野火烟雾暴露，我们的目标是：1）：分析宫内野火烟雾暴露与 出生结果。假设1a：在子宫内暴露于 野火的烟雾假设1b：在子宫内暴露于野火后，出生体重会下降 吸烟; 2）.检查子宫内野火烟雾暴露与生理稳定性之间的关系， 出生时的临床表现。假设2a：新生儿Apgar评分在出生后1分钟时会有差异。 子宫内野火烟雾暴露后的生活。假设2b。5分时阿普加评分会有差别 在子宫内暴露于野火烟雾后的生命时间。（3）第三章。研究子宫内野火 新生儿出生时吸烟暴露与重症监护需求假设：将增加 出生时在宫内野火烟雾暴露后进入NICU。这是对现有数据的二次分析 在华盛顿州进行基于人群的回顾性队列研究的三个来源。的 三个数据源包括：1.空气质量数据来自华盛顿州立大学实验室， 大气研究，2。覆盖经度坐标的地理信息系统（GIS）， 物理地址的纬度与空气质量数据和街区的其他空间特征， 母亲和3。产妇健康和新生儿出生结果数据可从华盛顿 州卫生部。在感兴趣的时间段（2010年至2016年），有611，182名新生儿 实际地址在西澳的母亲们。对于这三个目标中的每一个， （GLMM）框架将用于检查不良出生结局与暴露于 PM2.5，同时控制潜在的混杂变量。一个多学科的团队，在护理，空气 质量、空间分析和生物统计将支持这项工作。进行这项研究将建立在我的 作为新生儿重症监护护士的经验，并支持我作为护士科学家的职业生涯奠定了坚实的基础 重点是孕产妇和儿童的环境暴露。这项研究将建立科学， 更好地了解孕产妇和新生儿的结果与疾病的环境原因， 通知医院准备增加和持续的野火烟雾对孕产妇的影响 和儿童健康。