生命早期细颗粒物暴露与学龄期儿童孤独症谱系障碍患病风险的关联

目的 探索生命早期细颗粒物(PM_2.5)暴露与学龄期孤独症谱系障碍(ASD)患病风险的关联，为ASD的早期防控提供依据。方法 采用病例对照设计，于中山大学儿童青少年心理行为发育研究中心招募ASD儿童165名，同期于广州市部分小学招募性别年龄匹配的典型发育(TD)儿童165名。采用问卷收集基本资料，采用社交反应量表(SRS)评估儿童ASD的相关症状表现；采用中国大气成分近实时追踪数据集(TAP)估算生命早期PM_2.5暴露(母亲孕前、孕期及儿童出生后2年)。采用条件Logistic回归分析PM_2.5暴露与ASD患病风险的关联，广义线性回归模型分析PM_2.5暴露与ASD相关症状的关联。结果 ASD儿童母亲孕前1年(55.08±9.34)μg/m³,孕期(50.44±8.71)μg/m³以及ASD儿童出生后1年(45.04±8.25)μg/m³、出生后2年(40.19±7.12)μg/m³的PM_2.5

Correlation between early-life exposure to PM2.5 and risk of autism spectrum disorder among school-aged children

  Objective  To investigate the associations between early-life exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM_2.5) and the risk of autism spectrum disorder (ASD) among school-aged children.  Methods  A total of 165 children with ASD and 165 age-and gender-matched typical development (TD) children were recruited. Children's basic information were obtained via questionnaires, and the severity of ASD symptoms was assessed with Social Responsiveness Scale (SRS). Early-life PM_2.5 exposure (preconception, entire pregnancy, and the first two years after birth) were extracted from the Tracking Air Pollution in China (TAP) datasets. Conditional Logistic regression and generalized linear model were used to evaluate the associations of early-life exposure to PM_2.5 with the risk and the ASD severity symptoms, respectively.  Results  The PM_2.5 exposure of ASD group during preconception(55.08±9.34)μg/m3], entire pregnancy(50.44±8.71)μg/m3], the first year after birth (45.04±8.25)μg/m3] and the second year after birth (40.19±7.12)μg/m3] were significant higher than those in TD children (47.66±7.63, 44.19±7.16, 38.95±6.07, 35.76±5.65)μg/m3](t=7.94, 7.13, 7.70, 6.32, P < 0.05). After adjusting for potential confounding, each increase of 1 μg/m3 in PM_2.5 was associated with higher risk of ASD during preconception (OR=1.21, 95%CI=1.13-1.29), entire pregnancy(OR=1.18, 95%CI=1.11-1.26), the first year after birth (OR=1.30, 95%CI=1.18-1.43) and the second year after birth (OR=1.29, 95%CI=1.17-1.42). No similar results were observed regarding the analyses of SRS total and sub-scale scores(P>0.05).  Conclusion  Early-life exposure to PM_2.5 is relate to the risk of ASD, these findings indicated that more attention should be paid to ambient PM pollution in the early-life prevention and control of ASD.