Prenatal and postnatal exposure to PM2 .5 and the risk of tic disorders

Yu-Tzu Chang; Chau-Ren Jung; Ya-Chu Chang; Bao-Ru Chuang; Mei-Ling Chen; Bing-Fang Hwang

doi:10.1111/ppe.12943

Prenatal and postnatal exposure to PM₂ _.5 and the risk of tic disorders

Paediatr Perinat Epidemiol. 2023 Mar;37(3):191-200. doi: 10.1111/ppe.12943. Epub 2022 Dec 23.

Authors

Yu-Tzu Chang^{1

2}, Chau-Ren Jung^{3

4}, Ya-Chu Chang⁵, Bao-Ru Chuang⁵, Mei-Ling Chen⁶, Bing-Fang Hwang^{5

7}

Affiliations

¹ Division of Pediatric Neurology, China Medical University Children's Hospital, Taichung, Taiwan R.O.C.
² School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan R.O.C.
³ Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan R.O.C.
⁴ Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan.
⁵ Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan R.O.C.
⁶ College of Human Science and Social Innovation, HungKuang University, Taichung, Taiwan R.O.C.
⁷ Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan R.O.C.

PMID: 36562434
DOI: 10.1111/ppe.12943

Abstract

Background: Tic disorders are common neurodevelopmental disorders during childhood. Whether prenatal and postnatal exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM_2.5 ) plays a role in the development of tic disorders remains unexplored.

Objectives: To investigate the association of exposure between PM_2.5 during the pregnancy and infancy periods and the risk of tic disorders.

Methods: This birth cohort study recruited singleton live births at term gestations in central Taiwan from the Taiwan Maternal and Child Health Database between 2004 and 2012 and followed up to the end of 2017. New cases of tic disorders were defined using the ICD-9-CM (307.2) and ICD-10-CM (F95), which include all tic spectrum disorders. We assigned daily PM_2.5 concentrations derived from a satellite-based model to individuals based on maternal residential addresses at delivery. We fit Cox proportional hazard model and distributed lag non-linear model to estimate the associations between PM_2.5 and tic disorders, with hazard ratio (HR) with 95% confidence interval (CI) as the effect measure.

Results: Of the 309,376 singleton live births at term gestations, we identified 5902 (1.9%) tic disorder cases. The HR of tic disorders was positively associated with a 10 μg/m³ increase in PM_2.5 : during pregnancy HR 1.09, 95% CI 1.04, 1.15 and during infancy HR 1.12, 95% CI 1.06, 1.18. The vulnerable time window for infants with increased risk of tic disorders was 6-52 weeks after birth. We observed a nonlinear relationship between PM_2.5 and the risk of tic disorders, with exposure to PM_2.5 between 16 and 64 μg/m³ being associated with the risk of tic disorders. The association was restricted to Tourette's disorder group. Infant sex did not modify these associations.

Conclusions: Infants delivered at term and exposed to PM2.5 are associated with an increased risk of tic disorders (6-52 weeks). Further studies are needed to confirm these associations.

Keywords: Tourette's disorder; birth cohort; fine particulate matter; prenatal and postnatal exposure; tic disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants* / adverse effects
Air Pollution* / adverse effects
Air Pollution* / analysis
Child
Cohort Studies
Female
Humans
Infant
Maternal Exposure / adverse effects
Particulate Matter / adverse effects
Particulate Matter / analysis
Pregnancy
Tic Disorders* / epidemiology
Tic Disorders* / etiology
Vitamins

Substances

Air Pollutants
Particulate Matter
Vitamins