Portable HEPA filter air cleaner use during pregnancy and children’s autistic behaviors at four years of age: The UGAAR randomized controlled trial
Background: Developmental exposure to airborne particulate matter (PM) may increase children’s risk of developing autism spectrum disorder. We quantified the impact of reducing PM exposure during pregnancy on the development of autistic traits in children. We also assessed associations between indoo...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-10-01
|
| Series: | Environment International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412022003592 |
| _version_ | 1798003180958646272 |
|---|---|
| author | Undarmaa Enkhbat Enkhjargal Gombojav Chimeglkham Banzrai Sarangerel Batsukh Buyantushig Boldbaatar Enkhtuul Enkhtuya David C. Bellinger Bruce P. Lanphear Lawrence C. McCandless Ryan W. Allen |
| author_facet | Undarmaa Enkhbat Enkhjargal Gombojav Chimeglkham Banzrai Sarangerel Batsukh Buyantushig Boldbaatar Enkhtuul Enkhtuya David C. Bellinger Bruce P. Lanphear Lawrence C. McCandless Ryan W. Allen |
| author_sort | Undarmaa Enkhbat |
| collection | DOAJ |
| description | Background: Developmental exposure to airborne particulate matter (PM) may increase children’s risk of developing autism spectrum disorder. We quantified the impact of reducing PM exposure during pregnancy on the development of autistic traits in children. We also assessed associations between indoor fine PM (PM2.5) concentrations during pregnancy and autistic traits. Methods: In this parallel-group randomized controlled trial, we randomized 540 non-smoking pregnant women to receive HEPA filter air cleaners or to a control group, which did not receive air cleaners. We administered the Social Responsiveness Scale (SRS-2) to caregivers when children were a median of 48 months (range: 48 to 51 months). Our primary outcome was the SRS-2 total T-score. We imputed missing data using multiple imputation with chained equations and our primary analysis was by intention to treat. In secondary analyses, we estimated associations between full pregnancy and trimester-specific indoor PM2.5 concentrations and T-scores. Results: We enrolled participants at a median of 11 weeks’ gestation. Our analysis included 478 children (233 control, 245 intervention). The intervention reduced average indoor PM2.5 concentrations by 29 % (95 % CI: 21, 37 %). The mean SRS-2 total T-score was 0.5 units lower (95 % CI: −2.5, 1.5) among intervention participants, with evidence of larger benefits for children at the high end of the T-score distribution. An interquartile range (9.6 µg/m3) increase in indoor PM2.5 during pregnancy was associated with 1.8-unit (95 % CI: 0.3, 3.2) increase in mean SRS-2 total T-score. Effect estimates for PM2.5 concentrations by trimester were smaller and confidence intervals spanned no effect. Conclusion: Reducing indoor PM during pregnancy had little impact on mean autism-related behavior scores in children. However, indoor PM2.5 concentrations during pregnancy were associated with higher scores. Exposure to particulate matter during pregnancy may influence the development of autistic traits in childhood.Trial registration: ClinicalTrials.gov: NCT01741051. |
| first_indexed | 2024-04-11T12:05:15Z |
| format | Article |
| id | doaj.art-599e6b4e1ffb4755852fbc91b268d218 |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-04-11T12:05:15Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Environment International |
| spelling | doaj.art-599e6b4e1ffb4755852fbc91b268d2182022-12-22T04:24:45ZengElsevierEnvironment International0160-41202022-10-01168107432Portable HEPA filter air cleaner use during pregnancy and children’s autistic behaviors at four years of age: The UGAAR randomized controlled trialUndarmaa Enkhbat0Enkhjargal Gombojav1Chimeglkham Banzrai2Sarangerel Batsukh3Buyantushig Boldbaatar4Enkhtuul Enkhtuya5David C. Bellinger6Bruce P. Lanphear7Lawrence C. McCandless8Ryan W. Allen9Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada; School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, MongoliaSchool of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, MongoliaInstitute of Medical Sciences, Mongolian National University of Medical Sciences, Ulaanbaatar, MongoliaSchool of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, MongoliaSchool of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, MongoliaFaculty of Health Sciences, Simon Fraser University, Burnaby, BC, CanadaHarvard Medical School, Boston Children’s Hospital, Boston, MA, USAFaculty of Health Sciences, Simon Fraser University, Burnaby, BC, CanadaFaculty of Health Sciences, Simon Fraser University, Burnaby, BC, CanadaFaculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada; Corresponding author.Background: Developmental exposure to airborne particulate matter (PM) may increase children’s risk of developing autism spectrum disorder. We quantified the impact of reducing PM exposure during pregnancy on the development of autistic traits in children. We also assessed associations between indoor fine PM (PM2.5) concentrations during pregnancy and autistic traits. Methods: In this parallel-group randomized controlled trial, we randomized 540 non-smoking pregnant women to receive HEPA filter air cleaners or to a control group, which did not receive air cleaners. We administered the Social Responsiveness Scale (SRS-2) to caregivers when children were a median of 48 months (range: 48 to 51 months). Our primary outcome was the SRS-2 total T-score. We imputed missing data using multiple imputation with chained equations and our primary analysis was by intention to treat. In secondary analyses, we estimated associations between full pregnancy and trimester-specific indoor PM2.5 concentrations and T-scores. Results: We enrolled participants at a median of 11 weeks’ gestation. Our analysis included 478 children (233 control, 245 intervention). The intervention reduced average indoor PM2.5 concentrations by 29 % (95 % CI: 21, 37 %). The mean SRS-2 total T-score was 0.5 units lower (95 % CI: −2.5, 1.5) among intervention participants, with evidence of larger benefits for children at the high end of the T-score distribution. An interquartile range (9.6 µg/m3) increase in indoor PM2.5 during pregnancy was associated with 1.8-unit (95 % CI: 0.3, 3.2) increase in mean SRS-2 total T-score. Effect estimates for PM2.5 concentrations by trimester were smaller and confidence intervals spanned no effect. Conclusion: Reducing indoor PM during pregnancy had little impact on mean autism-related behavior scores in children. However, indoor PM2.5 concentrations during pregnancy were associated with higher scores. Exposure to particulate matter during pregnancy may influence the development of autistic traits in childhood.Trial registration: ClinicalTrials.gov: NCT01741051.http://www.sciencedirect.com/science/article/pii/S0160412022003592InterventionBrainProgrammingASDBehaviorDOHaD |
| spellingShingle | Undarmaa Enkhbat Enkhjargal Gombojav Chimeglkham Banzrai Sarangerel Batsukh Buyantushig Boldbaatar Enkhtuul Enkhtuya David C. Bellinger Bruce P. Lanphear Lawrence C. McCandless Ryan W. Allen Portable HEPA filter air cleaner use during pregnancy and children’s autistic behaviors at four years of age: The UGAAR randomized controlled trial Environment International Intervention Brain Programming ASD Behavior DOHaD |
| title | Portable HEPA filter air cleaner use during pregnancy and children’s autistic behaviors at four years of age: The UGAAR randomized controlled trial |
| title_full | Portable HEPA filter air cleaner use during pregnancy and children’s autistic behaviors at four years of age: The UGAAR randomized controlled trial |
| title_fullStr | Portable HEPA filter air cleaner use during pregnancy and children’s autistic behaviors at four years of age: The UGAAR randomized controlled trial |
| title_full_unstemmed | Portable HEPA filter air cleaner use during pregnancy and children’s autistic behaviors at four years of age: The UGAAR randomized controlled trial |
| title_short | Portable HEPA filter air cleaner use during pregnancy and children’s autistic behaviors at four years of age: The UGAAR randomized controlled trial |
| title_sort | portable hepa filter air cleaner use during pregnancy and children s autistic behaviors at four years of age the ugaar randomized controlled trial |
| topic | Intervention Brain Programming ASD Behavior DOHaD |
| url | http://www.sciencedirect.com/science/article/pii/S0160412022003592 |
| work_keys_str_mv | AT undarmaaenkhbat portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT enkhjargalgombojav portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT chimeglkhambanzrai portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT sarangerelbatsukh portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT buyantushigboldbaatar portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT enkhtuulenkhtuya portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT davidcbellinger portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT bruceplanphear portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT lawrencecmccandless portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial AT ryanwallen portablehepafilteraircleaneruseduringpregnancyandchildrensautisticbehaviorsatfouryearsofagetheugaarrandomizedcontrolledtrial |