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（CA）及其周边地区的野火暴露增加。 世界上吸烟的人口比近年来多得多。人们越来越关注 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，所有出生人口的3-5%，即，10多万 婴儿出生时有严重的先天缺陷。很少有研究来检验这种关系 野火烟雾和出生缺陷之间的关系，没有一个包括详细野火的研究人群， 烟雾暴露指标。没有一项研究包括了大量的基于人群的研究， 确认 我们建议编制一组独特的火灾发生、空气质量监测和建模数据集， 气象和住房特点的产妇住所在怀孕的关键时期， 在国家出生缺陷预防研究（NBDPS）中有和没有出生缺陷的儿童的母亲， 出生缺陷研究，以评估妊娠期缺陷S（BD-STEPS）研究，观察性，基于人群， 病例对照研究，2000-2018年在加州。例患者至少有22种主要出生缺陷中的一种， 心脏、大脑和脊柱、眼睛、耳朵、脸和嘴、肠道或肌肉和骨骼。详细的居住历史和 协变量数据可从参与者关于其怀孕经历的广泛访谈中获得， 一般健康和怀孕期间的药物使用。具体来说，我们的目标是估计22个主要风险 与野火烟雾暴露有关的结构性出生缺陷（20和50公里内的火灾烧毁区域，烟雾 频率，火源PM2.5和臭氧，以及多环芳烃）， 在发育的特定缺陷时期的早期妊娠。此外，我们还将调查 野火烟雾暴露与出生缺陷之间的关系（或缺乏关系）被邻居所改变 社会经济地位、心理压力或住房因素。 地理编码的居住史，医生确定的病例确定，广泛的协变量 收集，住房特点和详尽的空气污染和火灾测量和建模，我们的研究 将在高度暴露的地区进行迄今为止最精确的暴露评估和病例确定， 约这些发现有可能为有针对性的临床和公共卫生干预提供信息， 减少孕妇接触。

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.