Air Pollution during Pregnancy and Childhood Autism Spectrum Disorder in Taiwan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Cohort
2.2. Identification of Cases
2.3. Exposure Assessment
2.4. Covariates
2.5. Statistical Analysis
3. Results
3.1. Study Sample and Distribution of Patients
3.2. Levels of Air Pollutants
3.3. Results from Univariate Analyses of Covariates
3.4. Associations between Air Pollutants and Autism Spectrum Disorder
4. Discussion
4.1. Environmental Factors Contribute to Autism Spectrum Disorder
4.2. Associations of Air Pollution and Autism Spectrum Disorder
4.3. Trimester-Specific Associations
4.4. Strengths and Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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N (%) 1 | |||
---|---|---|---|
Variables | ASD (N = 466) | Non-ASD (N = 62,453) | p-Value |
Sex (male/female ratio) | 4.83 | 1.08 | <0.001 |
Male | 386 (82.83) | 32,427 (51.92) | |
Female | 80 (17.17) | 30,016 (47.72) | |
Birth year | 0.026 | ||
1996 | 78 (16.74) | 13,377 (21.42) | |
1997 | 90 (19.31) | 13,538 (21.68) | |
1998 | 101 (21.67) | 11,343 (18.16) | |
1999 | 101 (21.67) | 11,809 (18.91) | |
2000 | 96 (20.60) | 12,386 (19.83) | |
Followed year (mean ± SD 1) | 6.76 ± 4.02 | 15.30 ± 2.20 | |
Comorbidity | |||
Bipolar disorder | 9 (1.93) | 61 (0.10) | <0.001 |
Depressive disorder | 15 (3.22) | 195 (0.31) | <0.001 |
Anxiety | 66 (14.16) | 0 (0.00) | <0.001 |
Phobic disorder | 3 (0.64) | 60 (0.10) | 0.012 |
Obsessive compulsive disorder | 15 (3.22) | 70 (0.11) | <0.001 |
Intellectual disabilities | 149 (31.97) | 777 (1.24) | <0.001 |
Preterm birth | 10 (2.15) | 514 (0.82) | 0.006 |
Air pollutant level (mean ± SD) | |||
CO (ppm) | 0.89 ± 0.36 | 0.83 ± 0.32 | <0.001 |
NO2 (ppb) | 25.47 ± 6.12 | 24.34 ± 6.01 | <0.001 |
O3 (ppb) | 21.60 ± 3.61 | 21.99 ± 3.54 | 0.019 |
SO2 (ppb) | 5.76 ± 3.29 | 5.80 ± 3.47 | 0.783 |
PM10 (μg/m3) | 56.83 ± 15.24 | 60.27 ± 16.20 | <0.001 |
Covariate | Hazard Ratio | (95% CI) |
---|---|---|
Male | 4.45 | (3.50–5.66) * |
Calendar year | 1.12 | (1.05–1.20) * |
Comorbidity | ||
Bipolar disorder | 17.66 | (9.13–34.14) * |
Depressive disorder | 9.68 | (5.79–16.18) * |
Phobic disorder | 6.43 | (2.07–20.03) * |
Obsessive compulsive disorder | 25.98 | (15.54–43.44) * |
Intellectual disabilities | 34.26 | (28.20–41.63) * |
Preterm | 2.77 | (1.48–5.19) * |
Crude Hazard Ratio (95%CI) | Adjusted Hazard Ratio (95%CI) | ||
---|---|---|---|
Model 1 1 | Model 2 2 | ||
CO (ppm) | |||
Gestation | 1.65 (1.32–2.07) * | 1.77 (1.41–2.22) * | 1.88 (1.49–2.36) * |
1st Trimester | 1.68 (1.36–2.09) * | 1.79 (1.44–2.23) * | 1.93 (1.55–2.39) * |
2nd Trimester | 1.56 (1.25–1.96) * | 1.66 (1.33–2.09) * | 1.77 (1.41–2.22) * |
3rd Trimester | 1.57 (1.25–1.97) * | 1.68 (1.34–2.11) * | 1.75 (1.39–2.21) * |
NO2 (10 ppb) | |||
Gestation | 1.37 (1.18–1.60) * | 1.39 (1.19–1.62) * | 1.42 (1.22–1.66) * |
1st Trimester | 1.32 (1.17–1.50) * | 1.34 (1.19–1.52) * | 1.39 (1.22–1.58) * |
2nd Trimester | 1.22 (1.07–1.38) * | 1.22 (1.07–1.38) * | 1.25 (1.10–1.42) * |
3rd Trimester | 1.17 (1.04–1.33) * | 1.18 (1.04–1.34) * | 1.18 (1.03–1.34) * |
O3 (10 ppb) | |||
Gestation | 0.73 (0.56–0.96) * | 0.69 (0.52–0.91) * | 0.74 (0.56–0.97) * |
1st Trimester | 0.83 (0.68–1.02) | 0.81 (0.66–0.99) * | 0.85 (0.69–1.04) |
2nd Trimester | 0.82 (0.67–1.00) | 0.79 (0.64–0.97) * | 0.82 (0.67–1.02) |
3rd Trimester | 0.86 (0.70–1.05) | 0.83 (0.67–1.01) | 0.84 (0.68–1.03) |
SO2 (ppb) | |||
Gestation | 0.99 (0.97–1.02) | 1.00 (0.98–1.03) | 1.01 (0.99–1.04) |
1st Trimester | 1.00 (0.98–1.02) | 1.01 (0.99–1.03) | 1.02 (1.00–1.04) |
2nd Trimester | 0.99 (0.97–1.02) | 1.00 (0.98–1.03) | 1.01 (0.98–1.03) |
3rd Trimester | 0.99 (0.96–1.01) | 1.00 (0.97–1.02) | 1.00 (0.98–1.03) |
PM10 (10 μg/m3) | |||
Gestation | 0.86 (0.81–0.92) * | 0.87 (0.82–0.92) * | 0.90 (0.85–0.96) * |
1st Trimester | 0.95 (0.91–0.99) * | 0.96 (0.92–1.00) | 0.98 (0.94–1.03) |
2nd Trimester | 0.92 (0.89–0.96) * | 0.92 (0.88–0.96) * | 0.94 (0.90–0.99) * |
3rd Trimester | 0.90 (0.86–0.94) * | 0.90 (0.86–0.95) * | 0.91 (0.87–0.96) * |
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Wang, S.-Y.; Cheng, Y.-Y.; Guo, H.-R.; Tseng, Y.-C. Air Pollution during Pregnancy and Childhood Autism Spectrum Disorder in Taiwan. Int. J. Environ. Res. Public Health 2021, 18, 9784. https://doi.org/10.3390/ijerph18189784
Wang S-Y, Cheng Y-Y, Guo H-R, Tseng Y-C. Air Pollution during Pregnancy and Childhood Autism Spectrum Disorder in Taiwan. International Journal of Environmental Research and Public Health. 2021; 18(18):9784. https://doi.org/10.3390/ijerph18189784
Chicago/Turabian StyleWang, Shu-Yuan, Ya-Yun Cheng, How-Ran Guo, and Yen-Cheng Tseng. 2021. "Air Pollution during Pregnancy and Childhood Autism Spectrum Disorder in Taiwan" International Journal of Environmental Research and Public Health 18, no. 18: 9784. https://doi.org/10.3390/ijerph18189784