Environmental health perspectives · 2025
Ambient Toxic Air Contaminants in the Maternal Residential Area during Pregnancy and Cerebral Palsy in the Offspring.
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Zhuo Haoran, Ritz Beate, Warren Joshua L, Pollitt Krystal Godri, Liew Zeyan
Аннотация
BACKGROUND: Cerebral palsy (CP) is the most common permanent neuromotor disorder diagnosed in childhood. Although most cases have unknown etiology, emerging evidence suggests environmental risk factors of CP.
OBJECTIVES: We investigated whether ambient toxic air contaminants (TACs) in the maternal residential area during pregnancy, specifically volatile organic compounds (VOCs) and metals, were associated with offspring CP risk in California.
METHODS: We conducted a case-cohort study that included CP cases (N=906) and a 20% random sample of all live singleton births (N=184,954) who lived within a 5-mile (8-km) radius of air toxics monitoring stations in California during 2005-2015 as the control comparison group. CP cases were ascertained from diagnostic records of the California Department of Developmental Services. We a priori selected TACs with suspected neurotoxicity and developmental toxicity, including 14 VOCs and 6 metals. We estimated the adjusted risk ratio (RR) and 95% confidence interval (CI) for CP and the average maternal residential exposures to each TAC over the entire pregnancy using modified Poisson regression. For air contaminant mixtures, we used quantile-based g-computation to estimate the effects of mixtures of VOCs or metals. Finally, we performed a negative control exposure analysis on exposure estimates of 36-48 months after delivery to evaluate uncontrolled confounding bias.
RESULTS: Maternal residential exposures to six VOCs (benzene, toluene, 1,3-butadiene, acetone, acetonitrile, and methylene chloride) and four metals (antimony, lead, nickel, and vanadium) were associated with 3%-25% higher risk of CP per interquartile range increase, and the estimated mixture effects of VOCs (RR=1.24; 95% CI: 1.08, 1.43) or metals (RR=1.38; 95% CI: 1.20, 1.58) were stronger. The observed associations were close to null for negative control exposures (36-48 months after delivery) to mixtures of VOCs or metals and CP.
DISCUSSION: In California, maternal prenatal residential exposure to VOCs and metals in the outdoor air, largely attributed to mobile traffic emission sources, was associated with an increased risk of CP in offspring. https://doi.org/10.1289/EHP14742.
OBJECTIVES: We investigated whether ambient toxic air contaminants (TACs) in the maternal residential area during pregnancy, specifically volatile organic compounds (VOCs) and metals, were associated with offspring CP risk in California.
METHODS: We conducted a case-cohort study that included CP cases (N=906) and a 20% random sample of all live singleton births (N=184,954) who lived within a 5-mile (8-km) radius of air toxics monitoring stations in California during 2005-2015 as the control comparison group. CP cases were ascertained from diagnostic records of the California Department of Developmental Services. We a priori selected TACs with suspected neurotoxicity and developmental toxicity, including 14 VOCs and 6 metals. We estimated the adjusted risk ratio (RR) and 95% confidence interval (CI) for CP and the average maternal residential exposures to each TAC over the entire pregnancy using modified Poisson regression. For air contaminant mixtures, we used quantile-based g-computation to estimate the effects of mixtures of VOCs or metals. Finally, we performed a negative control exposure analysis on exposure estimates of 36-48 months after delivery to evaluate uncontrolled confounding bias.
RESULTS: Maternal residential exposures to six VOCs (benzene, toluene, 1,3-butadiene, acetone, acetonitrile, and methylene chloride) and four metals (antimony, lead, nickel, and vanadium) were associated with 3%-25% higher risk of CP per interquartile range increase, and the estimated mixture effects of VOCs (RR=1.24; 95% CI: 1.08, 1.43) or metals (RR=1.38; 95% CI: 1.20, 1.58) were stronger. The observed associations were close to null for negative control exposures (36-48 months after delivery) to mixtures of VOCs or metals and CP.
DISCUSSION: In California, maternal prenatal residential exposure to VOCs and metals in the outdoor air, largely attributed to mobile traffic emission sources, was associated with an increased risk of CP in offspring. https://doi.org/10.1289/EHP14742.