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（由申请人提供）：胎盘早剥给母亲和新生儿带来了巨大的健康负担，了解这种毁灭性产科并发症的基础的努力已经取得了进展。 该项目将描述导致胎儿早剥的途径，并确定与急性和慢性胎儿早剥有关的空气污染物触发因素的影响。鉴于所有胎儿早剥病例中有四分之一具有急性病因，因此环境触发因素的作用至关重要，该项目将利用与纽约市常住母亲死产和活产婴儿死亡相关的出院数据。 daa 包含地理编码的居住信息，包括 2008-14 年期间估计 840,000 名新生儿（约 7,000 例早产病例，其中 4,810 例为纽约市居民的“严重”病例）。对于每次怀孕，我们将分配细颗粒物的环境暴露情况与 n 空气动力学直径 <2.5 µM (PM2.5)，其成分（镍、锌和铁）、黑碳 (BC) 和气态污染物，包括二氧化氮 (NO2)、臭氧 (O3) 和二氧化硫 (SO2) 基分析的重点是通过病例交叉设计和那些分析这些空气污染物对急性早产病例的相对影响。考虑到空气污染物的普遍性及其对围产期不良后果的潜在影响，并且几乎没有关于胎盘早剥的数据，我们将采用队列设计与贝叶斯调整相结合的广义线性混合模型。拟议的项目提供了一个独特的机会，可以进行发现，改善孕产妇和婴儿健康并指导公共卫生政策。