Exposure to mobile source air pollution and adverse birth outcomes in the Los Ang

描述（由研究者提供）：我们将解决以前研究中的两个主要弱点，即空气污染与围产期结局的关系。第一个弱点，曝光误差，将解决一个全面的和大型的出生数据库与空间和时间分辨的曝光估计从先进的曝光建模系统。第二个弱点，即知识最少的时间活动和行为变化，影响妇女的个人暴露在怀孕期间，将解决以下前瞻性队列使用问卷调查和GPS时间活动采样。结局包括低出生体重（LBW）和早产（PTD）。将对前瞻性队列的超声结局进行探索性分析。长期目标将是开发可应用于大规模基于人口的出生研究的方法，其中将包括更深入的结果和暴露评估，以及母胎遗传变异评估。具体目的如下：1）在一个大的回顾性队列中确定母亲的住宅暴露于交通相关的空气污染物与LBW和PTD的关联。我们将研究该出生队列（N= 97，500），并提供母亲妊娠期间的详细临床数据。将估计每个住所的多环芳烃（PAH）、一氧化氮（NO）和二氧化氮（NO2）的室外浓度，并按月份和三个月总结每例受试者的情况。将进行Logistic回归，调整出生登记中通常不可用的已知或疑似混杂因素。将检查子宫内易受空气污染物影响的窗口。2)测试前瞻性招募方法，并开发可用于计划的大型超声数据研究的数据收集工具。我们将在首次产前访视期间前瞻性招募100名受试者。受试者将接受环境和行为问卷调查，并在怀孕期间进行为期一周的GPS采样三次。将评估怀孕期间时间活动和空气污染暴露的变化。此外，将开发方法来检查空气污染与超声结果（例如头围）的关联，这可能作为子宫内生长限制的生物标志物。3)测试测量和建模方法。我们将对40名潜在受试者进行广泛的暴露测量，并将开发和验证模型，以估计户外，运输和个人暴露。模型性能将构成更大规模研究设计的基础。公共卫生相关性通过识别和描述影响不良出生结局的环境因素，本研究将产生的知识将有益于公共卫生。预计这项研究将对保护易受空气污染不利影响的孕妇健康的决定产生影响。

DESCRIPTION (provided by investigator): We will address two major weaknesses in previous studies examining the association of air pollution with perinatal outcomes. The first weakness, exposure error, will be addressed by linking a comprehensive and large birth database with spatially and temporally resolved exposure estimates from an advanced exposure modeling system. The second weakness, namely, minimal knowledge concerning time-activity and behavior changes that affect women's personal exposures during pregnancy, will be addressed by following a prospective cohort using questionnaires and GPS time-activity sampling. Outcomes include low birth weight (LBW) and preterm delivery (PTD). Exploratory analysis will be conducted for ultrasound outcomes in the prospective cohort. The long-term goal will be to develop methods that can be applied to a large population- based study of births that will include more intensive outcome and exposure assessments, as well as assessments of maternal-fetal genetic variation. The specific aims are as follows: 1) To determine the association of mothers' residential exposure to traffic-related air pollutants with LBW and PTD in a large retrospective cohort. We will study this birth cohort (N=97,500) with detailed clinical data for the mother during pregnancy. Outdoor concentrations of polycyclic aromatic hydrocarbons (PAH), nitric oxide (NO), and nitrogen dioxide (NO2) at each residence will be estimated and summarized by month and trimester for each subject. Logistic regression will be performed adjusting for known or suspected confounding factors not generally available in birth registries. In utero windows of vulnerability to air pollutants will be examined. 2) To test prospective recruiting methods and develop data collection instruments that can be used in a planned larger study using ultrasound data. We will prospectively recruit 100 subjects during their first prenatal visit. The subjects will be followed by an environmental and behavior questionnaire coupled with one-week GPS sampling three times during their pregnancy. Changes in time-activity and air pollution exposures during pregnancy will be assessed. In addition, methods will be developed to examine the association of air pollution with ultrasound outcomes (e.g. head circumference), which may serve as biomarkers of in utero growth restrictions. 3) To test measurement and modeling methods. We will conduct extensive exposure measurements for 40 of the prospective subjects, and models will be developed and validated to estimate outdoor, in-transit and personal exposures. Model performance will form the basis for the design of a larger study. PUBLIC HEALTH RELEVANCE The knowledge that will emerge from this study will be of benefit to public health by identifying and describing environmental factors affecting adverse birth outcomes. This research is expected to have an impact on decisions regarding the protection of health in pregnant women who are susceptible to the adverse effects of air pollution.