Air Pollution and Risk of Placental Abruption in New York City

纽约市的空气污染和胎盘早剥的风险

• 批准号: 9096793
• 负责人: RONALD WAPNER
• 金额: $ 12万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9096793
• 关键词: Abruptio Placentae; Acute; Address; Admission activity; Adult; Affect; Air; Air Pollutants; Air Pollution; Birth; Birth Records; Caliber; Carbon; Carbon Black; Cessation of life; Chronic; Communities; Complication; Crossover Design; Data; Data Files; Diagnosis; Disseminated Intravascular Coagulation; Etiology; Event; Exposure to; Fetal Growth Retardation; First Pregnancy Trimester; Gestational Age; Goals; Health; Health Policy; Hospitals; Infant Health; Intensive Care; Iron; Kidney Failure; Life; Link; Live Birth; Maternal Health; Mental Health; Modeling; Monitor; Mothers; Nature; New York City; Newborn Infant; Nickel; Nitrogen Dioxide; Ozone; Particulate Matter; Pathway interactions; Perinatal mortality demographics; Pregnancy; Premature Birth; Prevalence; Public Health; Public Policy; Research; Research Design; Resources; Risk; Role; Shapes; Socioeconomic Status; Sulfur Dioxide; Surveys; System; Testing; Time; Trauma; Woman; Zinc; base; clinically relevant; cohort; design; improved; infant death; innovation; perinatal outcomes; policy implication; pollutant; population based; premature; residence; stillbirth

 DESCRIPTION(provided by applicant): Placental abruption places a tremendous health burden on both the mother and the newborn, and efforts to understand the underpinnings of this devastating obstetrical complication hav been disappointing. This project will delineate pathways to abruption and determine th impact of air pollutant triggers that are implicated in acute versus chronic abruptions Given that a fourth of all abruption cases have an acute etiology, the role of environental triggers is a critically important, yet unexplored, opportunity to understand the pahophysiology of abruption. The project will capitalize on hospital discharge data linked to both stillbirths and live birth-infant deaths to resident mothers in New York City. These daa, with geocoded residence information, include an estimated 840,000 births (about 7,000 abruption cases of which 4,810 will be "severe" cases to New York City residents during the period 2008-14. For each pregnancy, we will assign ambient exposure to fine particulate matter with n aerodynamic diameter <2.5 µM (PM2.5), its constituents (nickel, zinc, and iron), blak carbon (BC) and gaseous pollutants including nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2) based on residential address and gestational age at the time of the exposure. The analyses will focus on disentangling the relative contributions of these air pollutants on acute abruption cases through a case- crossover design and those of abruptions with chronic underpinnings using a cohort design. We will apply generalized linear mixed models integrated with the Bayesian adjustment for confounding. Given the ubiquitious nature of the air pollutants and their potential impact of adverse perinatal outcomes, and virtually no data on placental abruption, the proposed project represents a unique opportunity to make discoveries that will improve maternal and infant health and guide public health policy.

 描述（由申请人提供）：胎盘剥离给母亲和新生儿带来了巨大的健康负担，努力了解这种毁灭性产科并发症的基础， 令人失望 该项目将描绘预防途径，并确定急性与慢性预防中涉及的空气污染物触发因素的影响。鉴于所有预防病例中有四分之一具有急性病因，因此预防触发因素的作用至关重要，但尚未探索，有机会了解便秘的病理生理学。 该项目将利用与纽约市居民母亲死产和活产婴儿死亡有关的出院数据。 这些带有地理编码居住信息的数据包括估计840，000例出生（约7，000例妊娠病例，其中4，810例将是2008-14年期间纽约市居民的“严重”病例）。对于每一次怀孕，我们将指定环境暴露于细颗粒物， n空气动力学直径<2.5 µM（PM2.5），其成分（镍、锌和铁）、黑碳（BC）和气态污染物，包括二氧化氮（NO2）、臭氧（O3）和二氧化硫（SO2），基于暴露时的居住地址和胎龄。分析将侧重于通过病例交叉设计和使用队列设计的慢性基础的预防来解开这些空气污染物对急性预防病例的相对贡献。 我们将应用广义线性混合模型与贝叶斯调整混杂。鉴于空气污染物的普遍性及其对围产期不良结局的潜在影响，而且几乎没有有关胎盘早剥的数据，拟议的项目代表了一个独特的机会，可以发现改善孕产妇和婴儿健康并指导公共卫生政策的发现。