孕期臭氧暴露与幼儿神经心理发育关联的队列研究

Association between ozone exposure during pregnancy and neurodevelopment in 2-year-old children:A cohort study

目的 探究母亲孕期臭氧(Ozone, O_(3))暴露与2岁幼儿神经心理发育之间的关联。方法 基于2017年3月起于广州市越秀区妇幼保健院建立的出生队列,根据母亲家庭住址,采用基于遥感卫星数据的反演模型计算孕期(孕早、中、晚期)日最大8 h O_(3)浓度。在幼儿2岁时使用《年龄与发育进程问卷—第3版》(Ages and Stages Questionnaires, Third Edition, ASQ-3)评估其神经心理发育状况。采用多重线性回归和Logistic回归模型分析孕期O_(3)暴露和2岁幼儿ASQ-3各神经发育能区之间的关联。结果 孕期日最大8 h O_(3)浓度中位值为89.88μg/m^(3),其中孕晚期日最大8 h O_(3)浓度最大值为129.32μg/m^(3),且超标率达到52.63%。在校正混杂因素后,孕期日最大8 h O_(3)浓度每增加10μg/m^(3)分别与2岁幼儿的沟通(β=-8.79,95%CI:-16.73~-0.86)、粗大动作(β=-7.19,95%CI:-12.14~-2.23)、解决问题(β=-7.04,95%CI:-12.52~-1.56)以及个人—社会能区(β=-8.27,95%CI:-15.46~-1.07)的得分降低有关。孕晚期日最大8 h O_(3)浓度的增加与解决问题能区得分(β=-1.76,95%CI:-3.21~-0.31)降低相关。孕期日最大8 h O_(3)浓度越高,幼儿粗大动作能区和解决问题能区可疑发育异常的风险越高,调整后的OR(95%CI)分别为:4.92 (1.29, 20.72)和4.33 (1.10, 18.76)。结论 母亲孕期O_(3)暴露与2岁幼儿ASQ-3评分中沟通、粗大动作、解决问题及个人社会能区得分降低有关,并可能会增加2岁幼儿粗大动作和解决问题能区可疑发育异常的风险。

Objective To investigate the associations between ozone(O_(3))exposure during pregnancy and neurodevelopment in children at 2-year-old.Methods Based on the birth cohort established in Yuexiu Maternal and Child Health Hospital of Guangzhou since March 2017,the maximum 8-hour concentrations of O_(3) during pregnancy(first,second,and third trimesters)were calculated by using the inversion model based on remote sensing satellite data according to the maternal residential address.Ages and Stages Ques-tionnaire,Third Eidition(ASQ-3)was used to evaluate offsprings’neurodevelopment at 2 years old.Multiple linear regression and Logistic regression were performed to analyze the associations between ozone exposure during pregnancy and the neurodevelopmental do-mains at 2 years old.Results The medium of maximum 8-hour concentration of O_(3) during pregnancy was 89.88μg/m^(3),and the maxi-mum value of maximum 8-hour concentration of O_(3) in the third trimester was 129.32μg/m^(3) with an unqualified rate of 52.63%.After adjustment for confounding factors,each 10μg/m^(3) increase in the maximum 8-hour O_(3) concentration during pregnancy was associated with a decrease in the scores of communication(β=-8.79,95%CI:-16.73--0.86),gross motor(β=-7.19,95%CI:-12.14--2.23),problem-solving(β=-7.04,95%CI:-12.52--1.56),and person-social domains(β=-8.27,95%CI:-15.46--1.07).An increase of maximum 8-hour O_(3) concentration in the third trimester was associated with a decrease in the scores of prob-lem-solving domain(β=-1.76,95%CI:-3.21--0.31).The higher the maximum 8-hour concentrations of O_(3) during pregnancy,the higher the risks of potential developmental abnormalities in the children’s gross motor and problem-solving domains,and the adjusted OR(95%CI)were 4.92(1.29,20.72)and 4.33(1.10,18.76),respectively.Conclusion Prenatal O_(3) exposure during pregnan-cy was associated with decreased scores of communication,gross motor,problem-solving,and person-social domains of ASQ-3 in 2-year-old children,and might also increase the risk of potential abnormal development of gross motor and problem-solving domains in 2-year-old children.