背景:越来越多的证据将早期居住暴露与自然城市环境属性和儿童的积极健康结果联系起来。然而,很少有研究关注它们对自闭症谱系障碍(ASD)风险的保护作用。这项研究的目的是调查社区绿地的关联,和活跃的生活环境在怀孕期间与ASD的幼儿(≤6岁)。
方法:我们在安大略省进行了一项基于人群的配对病例对照研究,加拿大2012-2016年。ASD和环境数据是使用安大略省自闭症频谱生成的,更好的结果注册和网络安大略省,和加拿大城市环境卫生研究协会。我们采用条件逻辑回归来估计ASD和环境因素之间的比值比(OR),这些因素表征了选定的绿地指标和有利于活跃生活的社区(即,绿色视图指数(GVI)归一化植被指数(NDVI),树冠,公园接近度和活跃居住环境指数(ALE))。
结果:我们链接了8643对母子,包括1554例(18%)。NDVI(OR1.034,0.944-1.024,每四分位数范围[IQR]=0.08),GVI(OR1.025,95%CI0.953-1.087,每IQR=9.45%),在调整后的空气污染模型中,树冠(OR0.992,95%CI0.903-1.089,每个IQR=6.24%)和不同类别的ALE与ASD无关.相比之下,居住在靠近公园的地方是保护性的(OR0.888,0.833-0.948,公园接近指数每增加0.06),当针对空气污染进行调整时。
结论:这项研究报告了混合发现,显示绿色空间和活跃的生活环境对ASD的无效和有益影响。有必要进行进一步的研究,以阐明暴露于绿地和活跃的生活环境对ASD发展的作用。
BACKGROUND: Increasing evidence links early life residential exposure to natural urban environmental attributes and positive health outcomes in children. However, few studies have focused on their protective effects on the risk of autism spectrum disorder (ASD). The aim of this study was to investigate the associations of neighborhood greenspace, and active living environments during pregnancy with ASD in young children (≤6 years).
METHODS: We conducted a population-based matched
case-control study of singleton term births in Ontario, Canada for 2012-2016. The ASD and environmental data was generated using the Ontario Autism Spectrum Profile, the Better Outcomes Registry & Network Ontario, and Canadian Urban Environmental Health Research Consortium. We employed conditional logistic regressions to estimate the odds ratio (OR) between ASD and environmental factors characterizing selected greenspace metrics and neighborhoods conducive to active living (i.e., green view index (GVI), normalized difference vegetation index (NDVI), tree canopy, park proximity and active living environments index (ALE)).
RESULTS: We linked 8643 mother-child pairs, including 1554 cases (18%). NDVI (OR 1.034, 0.944-1.024, per Inter Quartile Range [IQR] = 0.08), GVI (OR 1.025, 95% CI 0.953-1.087, per IQR = 9.45%), tree canopy (OR 0.992, 95% CI 0.903-1.089, per IQR = 6.24%) and the different categories of ALE were not associated with ASD in adjusted models for air pollution. In contrast, living closer to a park was protective (OR 0.888, 0.833-0.948, per 0.06 increase in park proximity index), when adjusted for air pollution.
CONCLUSIONS: This study reported mixed findings showing both null and beneficial effects of green spaces and active living environments on ASD. Further investigations are warranted to elucidate the role of exposure to greenspaces and active living environments on the development of ASD.