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Maternal exposure to air pollution and risk of autism in children: A systematic review and meta-analysis.
Environ Pollut. 2020 Jan; 256:113307.EP

Abstract

BACKGROUND

The number of children diagnosed with autism spectrum disorder (ASD) has been increasing. Previous studies suggested potential association between pregnancy air pollution exposure and ASD. This systematic review and meta-analysis is intended to summarize the association between maternal exposure to outdoor air pollution and ASD in children by trimester based on recent studies.

METHODS

A systematic literature search in 3 databases (Medline, Embase, and Web of Science) was performed using subject headings related to ASD and air pollution since 2007. Eligible studies were screened and evaluated based on predetermined criteria. For meta-analyses, the studies were grouped by air pollutant and exposure time (prenatal period and trimesters). Within-group studies were standardized by log odds ratio (OR) and then combined by three meta-analysis methods: frequentist fixed and random effects models, and Bayesian random effects model.

RESULTS

Initial search identified 1564 papers, of which 25 studies remained for final analysis after duplicates and ineligible studies were removed. Of the 25 studies, 13, 14, 12, and 7 studies investigated ASD in children associated with PM2.5, PM10, NO2, and ozone, respectively. The frequentist and Bayesian random effects models resulted in different statistical significance. For prenatal period, frequentist meta-analysis returned significant pooled ORs with 95% confidence intervals, 1.06(1.01,1.11) for PM2.5 and 1.02(1.01,1.04) for NO2, whereas Bayesian meta-analysis showed similar ORs with wider 95% posterior intervals, 1.06(1.00,1.13) for PM2.5 and 1.02(1.00,1.05) for NO2. Third trimester appeared to have higher pooled ORs for PM2.5, PM10, and ozone, but patterns in the time-varying associations over the trimester were inconsistent.

CONCLUSIONS

For positive association between maternal exposure to ambient air pollution and ASD in children, there is some evidence for PM2.5, weak evidence for NO2 and little evidence for PM10 and ozone. However, patterns in associations over trimesters were inconsistent among studies and among air pollutants.

Authors+Show Affiliations

Jiann-Ping Hsu College of Public Health, Georgia Southern University, GA, USA.Department of Obstetrics, Gynecology, and Newborn Care, University of Ottawa, Ottawa, ON, Canada.Department of Obstetrics, Gynecology, and Newborn Care, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute Clinical Epidemiology, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada.Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, ON, Canada. Electronic address: hwashin.shin@canada.ca.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

31733973

Citation

Chun, HeeKyoung, et al. "Maternal Exposure to Air Pollution and Risk of Autism in Children: a Systematic Review and Meta-analysis." Environmental Pollution (Barking, Essex : 1987), vol. 256, 2020, p. 113307.
Chun H, Leung C, Wen SW, et al. Maternal exposure to air pollution and risk of autism in children: A systematic review and meta-analysis. Environ Pollut. 2020;256:113307.
Chun, H., Leung, C., Wen, S. W., McDonald, J., & Shin, H. H. (2020). Maternal exposure to air pollution and risk of autism in children: A systematic review and meta-analysis. Environmental Pollution (Barking, Essex : 1987), 256, 113307. https://doi.org/10.1016/j.envpol.2019.113307
Chun H, et al. Maternal Exposure to Air Pollution and Risk of Autism in Children: a Systematic Review and Meta-analysis. Environ Pollut. 2020;256:113307. PubMed PMID: 31733973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal exposure to air pollution and risk of autism in children: A systematic review and meta-analysis. AU - Chun,HeeKyoung, AU - Leung,Cheryl, AU - Wen,Shi Wu, AU - McDonald,Judy, AU - Shin,Hwashin H, Y1 - 2019/09/26/ PY - 2019/03/22/received PY - 2019/08/22/revised PY - 2019/09/24/accepted PY - 2019/11/18/pubmed PY - 2019/11/18/medline PY - 2019/11/18/entrez KW - Air pollution KW - Autism spectrum disorder (ASD) KW - Bayesian random effects model KW - Meta-analysis KW - Prenatal KW - Systematic review KW - Time-varying association KW - Trimester SP - 113307 EP - 113307 JF - Environmental pollution (Barking, Essex : 1987) JO - Environ. Pollut. VL - 256 N2 - BACKGROUND: The number of children diagnosed with autism spectrum disorder (ASD) has been increasing. Previous studies suggested potential association between pregnancy air pollution exposure and ASD. This systematic review and meta-analysis is intended to summarize the association between maternal exposure to outdoor air pollution and ASD in children by trimester based on recent studies. METHODS: A systematic literature search in 3 databases (Medline, Embase, and Web of Science) was performed using subject headings related to ASD and air pollution since 2007. Eligible studies were screened and evaluated based on predetermined criteria. For meta-analyses, the studies were grouped by air pollutant and exposure time (prenatal period and trimesters). Within-group studies were standardized by log odds ratio (OR) and then combined by three meta-analysis methods: frequentist fixed and random effects models, and Bayesian random effects model. RESULTS: Initial search identified 1564 papers, of which 25 studies remained for final analysis after duplicates and ineligible studies were removed. Of the 25 studies, 13, 14, 12, and 7 studies investigated ASD in children associated with PM2.5, PM10, NO2, and ozone, respectively. The frequentist and Bayesian random effects models resulted in different statistical significance. For prenatal period, frequentist meta-analysis returned significant pooled ORs with 95% confidence intervals, 1.06(1.01,1.11) for PM2.5 and 1.02(1.01,1.04) for NO2, whereas Bayesian meta-analysis showed similar ORs with wider 95% posterior intervals, 1.06(1.00,1.13) for PM2.5 and 1.02(1.00,1.05) for NO2. Third trimester appeared to have higher pooled ORs for PM2.5, PM10, and ozone, but patterns in the time-varying associations over the trimester were inconsistent. CONCLUSIONS: For positive association between maternal exposure to ambient air pollution and ASD in children, there is some evidence for PM2.5, weak evidence for NO2 and little evidence for PM10 and ozone. However, patterns in associations over trimesters were inconsistent among studies and among air pollutants. SN - 1873-6424 UR - https://www.unboundmedicine.com/medline/citation/31733973/Maternal_exposure_to_air_pollution_and_risk_of_autism_in_children:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0269-7491(19)31469-1 DB - PRIME DP - Unbound Medicine ER -