孕期臭氧暴露与幼儿神经心理发育关联的队列研究

吴输; 陈宇靖; 陆青贵; 成杨阳; 李晓旭; 刘楠; 刘渝; 林力孜; 蔡莉

doi:10.13421/j.cnki.hjwsxzz.2024.03.001

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

摘要

摘要:
目的探究母亲孕期臭氧(Ozone，O₃)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 O₃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O₃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 O₃浓度中位值为89.88 μg/m³，其中孕晚期日最大8 h O₃浓度最大值为129.32 μg/m³，且超标率达到52.63%。在校正混杂因素后，孕期日最大8 h O₃浓度每增加10 μg/m³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 O₃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 O₃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O₃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。

Abstract:
Objective To investigate the associations between ozone(O₃) 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 O₃ 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 Questionnaire, 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 domains at 2 years old.
Results The medium of maximum 8-hour concentration of O₃ during pregnancy was 89.88 μg/m³, and the maximum value of maximum 8-hour concentration of O₃ in the third trimester was 129.32 μg/m³ with an unqualified rate of 52.63%. After adjustment for confounding factors, each 10 μg/m³ increase in the maximum 8-hour O₃ 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 O₃ concentration in the third trimester was associated with a decrease in the scores of problem-solving domain (β=-1.76, 95%CI: -3.21--0.31). The higher the maximum 8-hour concentrations of O₃ 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 O₃ exposure during pregnancy 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.

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