Wildfire Smoke Exposure in Pregnancy and Risk of Structural Birth Defects

项目摘要 气候变化继续导致加州和周边地区暴露在野火中的风险增加 世界各地的烟民人数比近几年多得多。人们越来越关注人类的健康 这些火灾的影响，特别是对孕妇及其发育中的胚胎/胎儿。出生缺陷是 是美国婴儿死亡的主要原因。在美国，3%-5%的新生儿，即超过10万人 婴儿/年，出生时就有严重的出生缺陷。很少有研究对这种关系进行考察。 野火烟雾和出生缺陷之间的关系，没有一个包括详细的野火研究人群 烟雾暴露指标。没有一项包括大规模的基于人群的研究和彻底的病例 确定。 我们建议汇编一组独特的火灾发生、空气质量监测和建模的数据集， 青岛市孕期危重期孕产妇住宅的气象和住房特征 全国出生缺陷预防研究(NBDPS)中有出生缺陷和无出生缺陷儿童的母亲和 评估妊娠暴露的出生缺陷研究(BD-STEPS)研究，观察性，基于人群， 病例对照研究，2000年至2018年在加利福尼亚州。这些病例至少有22例严重出生缺陷中的一例 心脏、大脑和脊椎、眼睛、耳朵、脸和嘴、肠道或肌肉和骨骼。详细的住宅历史和 协变量数据来自对参与者的广泛采访，涉及他们的怀孕经历和 一般健康和怀孕期间的药物使用。具体地说，我们的目标是估计22个主要 与野火烟雾暴露有关的结构先天缺陷(20至50公里范围内的火灾烧伤区域，烟雾 年产妇住所的频率、火源PM2.5和臭氧以及多环芳烃) 在特定发育缺陷期的早期妊娠。此外，我们将调查是否 邻里关系改变野火烟雾暴露与出生缺陷之间的关系(或缺乏关系) 社会经济地位、心理社会压力或住房因素。 有地理编码的住宅史，医生确定的病例，广泛的协变量 收集、住房特征和详尽的空气污染以及火灾测量和建模，我们的研究 将在一个高度暴露的地区进行迄今为止最准确的暴露评估和病例确定 加州。这些发现有可能为有针对性的临床和公共卫生干预措施提供信息，旨在 减少与孕妇的接触。

Project Summary Climate change continues to result in increased exposure to wildfires in California (CA) and around the world with smoke reaching far more populations than in recent years. There is increased concern for the health effects of these fires, especially for pregnant people and their developing embryos/fetuses. Birth defects are the leading cause of infant mortality in the US. In the US, 3-5% of all births, i.e., more than 100,000 babies/year, are born with a major birth defect. Few studies have been conducted to examine the relationship between wildfire smoke and birth defects, and none have included study populations with detailed wildfire smoke exposure metrics. None have included large population-based studies with thorough case ascertainment. We propose to compile a unique group of datasets of fire occurrence, air quality monitoring and modeling, meteorology and housing characteristics of the maternal residence during critical periods of pregnancy for mothers of children with and without birth defects in the National Birth Defects Prevention Study (NBDPS) and Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS) Study, observational, population-based, case-control studies, between 2000-2018 in California. Cases had at least one of 22 major birth defects of the heart, brain and spine, eye, ear, face and mouth, gut, or muscles and bones. Detailed residential history and covariate data are available from extensive interviews of participants about their pregnancy experience and general health, and medication use during pregnancy. Specifically, we aim to estimate the risk of 22 major structural birth defects in relation to wildfire smoke exposures (fire burned area within 20 and 50km, smoke frequencies, fire-sourced PM2.5 and ozone, and polycyclic aromatic hydrocarbons) at the maternal residence in early pregnancy during defect-specific periods of development. Additionally, we will investigate whether the relationship (or lack thereof) between wildfire smoke exposure and birth defects is modified by neighborhood socioeconomic status, psychosocial stress or housing factors. With geocoded residential history, physician determined case ascertainment, extensive covariate collection, housing characteristics and exhaustive air pollution and fire measurement and modeling, our study will have the most precise exposure assessment and case ascertainment to date in a highly exposed region of CA. The findings have the potential to inform targeted clinical and public health interventions designed to reduce exposures to pregnant people.