Air Pollution and Risk of Placental Abruption in New York City

纽约市的空气污染和胎盘早剥的风险

• 批准号: 9096793
• 负责人: RONALD WAPNER
• 金额: $ 12万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9096793
• 关键词: Abruptio Placentae; Acute; Address; Admission activity; Adult; Affect; Air; Air Pollutants; Air Pollution; Birth; Birth Records; Caliber; Carbon; Carbon Black; Cessation of life; Chronic; Communities; Complication; Crossover Design; Data; Data Files; Diagnosis; Disseminated Intravascular Coagulation; Etiology; Event; Exposure to; Fetal Growth Retardation; First Pregnancy Trimester; Gestational Age; Goals; Health; Health Policy; Hospitals; Infant Health; Intensive Care; Iron; Kidney Failure; Life; Link; Live Birth; Maternal Health; Mental Health; Modeling; Monitor; Mothers; Nature; New York City; Newborn Infant; Nickel; Nitrogen Dioxide; Ozone; Particulate Matter; Pathway interactions; Perinatal mortality demographics; Pregnancy; Premature Birth; Prevalence; Public Health; Public Policy; Research; Research Design; Resources; Risk; Role; Shapes; Socioeconomic Status; Sulfur Dioxide; Surveys; System; Testing; Time; Trauma; Woman; Zinc; base; clinically relevant; cohort; design; improved; infant death; innovation; perinatal outcomes; policy implication; pollutant; population based; premature; residence; stillbirth

 DESCRIPTION(provided by applicant): Placental abruption places a tremendous health burden on both the mother and the newborn, and efforts to understand the underpinnings of this devastating obstetrical complication hav been disappointing. This project will delineate pathways to abruption and determine th impact of air pollutant triggers that are implicated in acute versus chronic abruptions Given that a fourth of all abruption cases have an acute etiology, the role of environental triggers is a critically important, yet unexplored, opportunity to understand the pahophysiology of abruption. The project will capitalize on hospital discharge data linked to both stillbirths and live birth-infant deaths to resident mothers in New York City. These daa, with geocoded residence information, include an estimated 840,000 births (about 7,000 abruption cases of which 4,810 will be "severe" cases to New York City residents during the period 2008-14. For each pregnancy, we will assign ambient exposure to fine particulate matter with n aerodynamic diameter <2.5 µM (PM2.5), its constituents (nickel, zinc, and iron), blak carbon (BC) and gaseous pollutants including nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2) based on residential address and gestational age at the time of the exposure. The analyses will focus on disentangling the relative contributions of these air pollutants on acute abruption cases through a case- crossover design and those of abruptions with chronic underpinnings using a cohort design. We will apply generalized linear mixed models integrated with the Bayesian adjustment for confounding. Given the ubiquitious nature of the air pollutants and their potential impact of adverse perinatal outcomes, and virtually no data on placental abruption, the proposed project represents a unique opportunity to make discoveries that will improve maternal and infant health and guide public health policy.

 描述（应用程序提供）：胎盘破裂给母亲和新生儿带来了巨大的健康伯恩，并努力了解这种毁灭性的产科并发症的基础 该项目将描述出现的途径并确定空气污染物触发因素在急性与慢性破坏中实施的影响，因为所有破裂病例中的四分之一具有急性病因，环境触发的作用是至关重要的，但意外的，出乎意料的，出乎意料的，有机会理解失败物理学的机会。该项目将利用与静物生日和纽约市居民母亲的现场生下死亡有关的医院出院数据。这些DAA带有地理编码的居住信息，包括估计有840,000个出生（大约7,000例突发案例，其中4,810例将在2008 - 14年期间对纽约市居民“严重”。对于每个怀孕 N空气动力学直径<2.5 µm（PM2.5），其成分（镍，锌和铁），Blak Carbon（BC）和气态污染物，包括二氧化氮（NO2），臭氧（O3）和二氧化碳（SO2），基于住宅地址和GESTAINTIAN EPERATICAT EXTOPERATION GESTAINTION GESTORICATION EXTOUSS，这些分析将着重于通过案例穿透设计以及使用队列设计的慢性基础设计来解散这些空气污染物对急性破坏情况的相对贡献。我们将应用与贝叶斯调整集成的广义线性混合模型进行混杂。鉴于空气污染物的无处不在性质及其对不良围产期结果的潜在影响，几乎没有关于置换式爆发的数据，因此拟议的项目代表了一个独特的机会，可以进行发现，以改善孕产妇和婴儿的健康并指导公共卫生政策。