TY - JOUR
T1 - Modification of caesarean section on the associations between air pollution and childhood asthma in seven Chinese cities
AU - Yu, Hongyao
AU - Guo, Yuming
AU - Zeng, Xiaoyun
AU - Gao, Meng
AU - Yang, Bo Yi
AU - Hu, Li Wen
AU - Yu, Yunjiang
AU - Dong, Guang Hui
AU - Zhou, Yang
AU - Qian, Zhengmin
AU - Sun, Jia
AU - McMillin, Stephen Edward
AU - Bloom, Michael S.
AU - Heinrich, Joachim
AU - Markevych, Iana
AU - Morawska, Lidia
AU - Dharmage, Shyamali C.
AU - Jalaludin, Bin
AU - Knibbs, Luke
AU - Lin, Shao
AU - Jalava, Pasi
AU - Roponen, Marjut
AU - Leskinen, Ari
AU - Komppula, Mika
AU - Hung-Lam Steve, Y. I.M.
AU - Liu, Ru Qing
AU - Zeng, Xiao Wen
AU - Seven Northeastern Cities Study group
N1 - Funding Information:
This work was supported by the National Natural Science Foundation of China ( 81872582 , 91543208 , 81872583 , 81673128 , and 81703179 ), the National Key Research and Development Program of China ( 2018YFE0106900 ), the Guangdong Provincial Natural Science Foundation Team Project ( 2018B030312005 ), the Guangdong Province Natural Science Foundation ( 2017A050501062 , and 2018B05052007 ), and the Fundamental Research Funds for the Central Universities ( 19ykjc01 ).
PY - 2020/12
Y1 - 2020/12
N2 - It is unknown whether giving birth via caesarean section (c-section) is a modifier for the association between air pollution and asthma. From 2012 to 2013, 59,754 children between the ages of 2 and 17 were randomly selected from 94 middle schools, elementary schools and kindergartens in seven Chinese cities for a cross-sectional study. The children's parents or guardians completed questionnaires, from which data on asthma as well as asthma-related symptoms were obtained. Participants' exposure to particles with an aerodynamic diameter ≤1.0 μm (PM1), ≤2.5 μm (PM2.5), and ≤10 μm (PM10) and exposure to nitrogen dioxide (NO2) were estimated using random forest models. We used mixed effects logistic regression models and added an interaction term between mode of delivery and ambient air pollution into the model to estimate effect modification from c-sections after appropriate adjustments for potential confounding variables. Among children delivered by c-section, the adjusted ORs for asthma and its symptoms per interquartile range (IQR) increase of PM1, PM2.5, PM10 and NO2 (1.20 95% CI: 1.07–1.34 to 2.04 95% CI: 1.87–2.24) were significantly higher than those of children delivered vaginally (1.05 95% CI: 0.92–1.19 to 1.33 95%CI: 1.21–1.47). The interactions between c-sections and ambient air pollution were statistically significant for all studied respiratory disorders, except current wheeze. Delivery via c-section may increase the risks of air pollution on asthma and its symptoms in Chinese children.
AB - It is unknown whether giving birth via caesarean section (c-section) is a modifier for the association between air pollution and asthma. From 2012 to 2013, 59,754 children between the ages of 2 and 17 were randomly selected from 94 middle schools, elementary schools and kindergartens in seven Chinese cities for a cross-sectional study. The children's parents or guardians completed questionnaires, from which data on asthma as well as asthma-related symptoms were obtained. Participants' exposure to particles with an aerodynamic diameter ≤1.0 μm (PM1), ≤2.5 μm (PM2.5), and ≤10 μm (PM10) and exposure to nitrogen dioxide (NO2) were estimated using random forest models. We used mixed effects logistic regression models and added an interaction term between mode of delivery and ambient air pollution into the model to estimate effect modification from c-sections after appropriate adjustments for potential confounding variables. Among children delivered by c-section, the adjusted ORs for asthma and its symptoms per interquartile range (IQR) increase of PM1, PM2.5, PM10 and NO2 (1.20 95% CI: 1.07–1.34 to 2.04 95% CI: 1.87–2.24) were significantly higher than those of children delivered vaginally (1.05 95% CI: 0.92–1.19 to 1.33 95%CI: 1.21–1.47). The interactions between c-sections and ambient air pollution were statistically significant for all studied respiratory disorders, except current wheeze. Delivery via c-section may increase the risks of air pollution on asthma and its symptoms in Chinese children.
KW - Air pollution
KW - Asthma
KW - Asthma-related symptom
KW - Caesarean section
KW - Effect modification
UR - http://www.scopus.com/inward/record.url?scp=85090155322&partnerID=8YFLogxK
U2 - 10.1016/j.envpol.2020.115443
DO - 10.1016/j.envpol.2020.115443
M3 - Journal article
C2 - 32892008
AN - SCOPUS:85090155322
SN - 0269-7491
VL - 267
JO - Environmental Pollution
JF - Environmental Pollution
M1 - 115443
ER -
