Impact of household air pollution (HAP) in-utero through early childhood on neurocognitive development from infancy to 8 years (HAPCOG Study)

童年时期宫内家庭空气污染 (HAP) 对婴儿期至 8 岁神经认知发展的影响（HAPCOG 研究）

• 批准号: 10373059
• 负责人: CHRISTOPHER O OLOPADE
• 金额: $ 61.24万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10373059
• 关键词: 4 year old; 8 year old; Affect; Africa South of the Sahara; Age; Air; Air Pollution; Alcohol consumption; Biological Markers; Biomass; Blood; Brain; Carbon Black; Cardiovascular system; Cessation of life; Child; Chronic; Cognitive; Communities; Cookstove; Deposition; Development; Enrollment; Ethanol; Exposure to; Fetal Development; Fetal Growth Retardation; Future; Gases; Gestational Age; Goals; Grain; Growth; Health; Health Policy; Heavy Metals; Histologic; Home; Home environment; Household; Household Air Pollution; Hypertension; Hypoxia; Impairment; Infant; Inflammation; Inflammatory; Inhalation; Kerosene; Language; Lead; Low Birth Weight Infant; Mediating; Micronutrients; Modeling; Monitor; Mothers; Motor; Nervous System Physiology; Nervous System Trauma; Neurocognition; Neurocognitive; Neurocognitive Deficit; Neurologic; Newborn Infant; Nigeria; Nigerian; Nutritional status; Outcome; Oxidative Stress; Oxygen; Particulate Matter; Performance; Personal Satisfaction; Placenta; Policies; Pregnancy; Pregnancy Outcome; Pregnancy Trimesters; Pregnant Women; Premature Birth; Psychosocial Stress; Public Health; Questionnaires; Randomized; Randomized Controlled Trials; Reporting; Research; Risk; Risk Factors; Sampling; Second Pregnancy Trimester; Spontaneous abortion; Stress; System; Testing; Third Pregnancy Trimester; Translating; Validation; Variant; Vascularization; Woman; Work; adverse pregnancy outcome; attributable mortality; base; biomass fuel; brain tissue; cardiovascular injury; cohort; cooking; cytokine; deprivation; early childhood; executive function; fine particles; in utero; infancy; injured airway; low and middle-income countries; maternal stress; pollutant; postnatal; pregnant; prenatal; programs; psychosocial wellbeing; respiratory; systemic inflammatory response

ABSTRACT Around the world, 93% of children under age 15 breathe toxic air every day that puts their health and development at risk. Of 7 million deaths per year attributable to air pollution, over 60% are due to exposure to household air pollution (HAP) from burning biomass fuels or kerosene for household energy needs. Such fuels burn inefficiently, producing toxic pollutants like fine particulate matter (PM2.5) and black carbon (BC). Mothers and children suffer the highest exposures, resulting in respiratory, cardiovascular, and neurologic injury. Risks to children begin in-utero. Pregnant women inhale polluted air, with ill effects on their developing fetuses and newborns, including growth restriction, preterm birth, and low birth weight. Mounting evidence suggests that HAP can impair infant and child neurocognitive development. Particulate matter deposits in brain tissue have been demonstrated; also, HAP is a medium of exposure to heavy metals. High exposures likely induce oxidative stress and systemic inflammation. There is evidence of mediating factors: maternal stress level, mother/child nutritional status, and home environment. We will explore the impact of HAP exposures on child neurocognitive development, assessing the influence of known mediating factors. Our research capitalizes on a unique opportunity flowing from a recent randomized controlled trial (RCT) in Nigeria. We randomized 324 pregnant women into groups based on fuel use: clean versus polluting. Polluting-fuel users showed: 1) increased preterm delivery, miscarriage, and reduced gestational age at delivery, 2) biomarkers of placental oxygen deprivation, 3) excessive placental vascularization, and 4) increased systemic inflammation. We further found that polluting-fuel users reported more psychosocial stress and less energy during pregnancy. We have continued to follow the RCT children (DISCOVERY COHORT), monitoring their HAP exposures. We propose now to test the hypothesis that high pre- and postnatal HAP exposure negatively impacts neurocognitive development. We will assess development in our DISCOVERY COHORT and an added VALIDATION COHORT of newborns from a new group of pregnant (3rd trimester) women. We will monitor personal HAP exposures of mothers and children, assessing biomarkers of inflammation and oxidative stress and blood levels of micronutrients and heavy metals. We aim to assess neurocognitive development from infancy to age 8 years as associated with: (1) prenatal and early childhood HAP exposures; (2) maternal psychosocial stress level, maternal and child nutritional status, and child's home environment. Impact: Results will illuminate how HAP exposures and maternal stress affect child neurocognitive development, informing policies to reduce HAP through programs that promote use of clean-fuel cookstoves. We will develop language/culturally-adapted assessments of child neurocognition—much needed in sub-Saharan Africa—and establish pilot performance norms. This will build capacity for more research of this kind in Nigeria in the future.

抽象的 世界各地，每天有93％的15岁以下儿童呼吸有毒的空气，使他们的健康和 有风险的发展。每年造成空气污染的700万人死亡，超过60％是由于暴露于 家庭空气污染（HAP）燃烧​​生物量燃料或煤油满足家庭能源需求。 燃烧效率低下，产生有毒污染物，例如精美的特殊物质（PM2.5）和黑碳（BC）。母亲 儿童的暴露率最高，导致呼吸道，心血管损伤。风险 对孩子开始在Utero中开始。孕妇吸入污染空气，对其发育中的胎儿和 新生儿，包括生长限制，早产和低出生体重。越来越多的证据表明 HAP会损害婴儿和儿童神经认知的发展。颗粒物沉积在脑组织中 已经证明了；同样，HAP是暴露于重金属的媒介。高暴露可能引起 氧化应激和全身炎症。有介导因子的证据：物物应力水平， 母/儿童营养状况和家庭环境。我们将探索HAP暴露对儿童的影响 神经认知发展，评估已知中介因子的影响。我们的研究大写 来自尼日利亚最近的一项随机对照试验（RCT）的独特机会。我们随机324 孕妇根据燃料使用：清洁与污染。污染燃料用户显示：1） 早产增加，流产和胎龄减少，2）生物标志物的生物标志物 氧气剥夺，3）过度的占地血管和4）增加全身注射。我们进一步 发现污染的燃料使用者报告了怀孕期间更多的社会心理压力和减少能量。我们有 继续跟随RCT儿童（发现队列），监视他们的HAP暴露。我们现在提出 为了检验高产前和产后HAP暴露会对神经认知产生负面影响的假设 发展。我们将评估我们的发现队列中的发展，并附加验证队列 来自新的孕妇（三个月）的新生儿。我们将监视个人HAP暴露 母亲和儿童，评估炎症和氧化应激的生物标志物以及血液水平 微量营养素和重金属。我们旨在评估从婴儿期到8岁的神经认知发展 与：（1）产前和幼儿相关的HAP暴露； （2）孕产妇的社会心理压力水平， 孕产妇营养状况以及儿童家庭环境。影响：结果将阐明如何HAP 暴露和母校压力会影响儿童神经认知的发展，告知政策以减少HAP 通过促进清洁燃料烹饪炉的程序。我们将发展语言/文化适应 对儿童神经认知的评估 - 撒哈拉以南非洲所需的问题，并建立了飞行员表现 规范。这将在未来在尼日利亚进行更多研究的能力。