大台北地區空氣污染及土地利用型態對極低出生體重早產兒六個月大時神經發展之影響

The Effects of Air Pollution and Land Use Types on Neurodevelopment at Six Months among Very Low Birth Weight Preterm Children in the Greater Taipei Area

楊喻婷(Yu-Ting Yang) ； 江椿彬(Chuen-Bin Jiang) ； 簡伶朱(Ling-Chu Chien) ； 吳治達(Chih-Da Wu) ； 趙馨(Hsing Jasmine Chao)

《航測及遙測學刊》 24卷1期 (2019/03) Pp. 45-58

https://doi.org/10.6574/JPRS.201903_24(1).0004

摘要

空氣污染是全球性的環境問題，造成多種健康危害。近年來有研究調查發現，出生前後的空氣污染物暴露會影響兒童神經功能的發展。因此本研究評估在大台北地區出生的極低出生體重早產兒，出生前後空氣污染物暴露及住家附近土地利用型態與六個月時（矯正年齡）神經功能發展間的相關性。本研究利用地理資訊系統，評估受訪兒童在媽媽懷孕期間及出生至六個月住家戶外空氣污染物濃度以及土地利用特性。在受訪兒童神經發展評估部份，利用第三版貝萊嬰幼兒發展量表進行。其他受訪兒童相關資料，如出生前後居住地、基本社會人口學特徵、家中污染物暴露等等，則利用結構式問卷及病歷收集。受訪兒童空氣污染物暴露及住家附近土地利用特性與神經功能發展間的相關性，以多變項迴歸分析評估。根據迴歸分析結果，多項空氣污染物（O_3、PM_(10)、NO及NO_2）對兒童神經功能發展有不良的影響，其中又以媽媽懷孕期間的空氣污染物暴露濃度對兒童影響較大。在土地利用型態方面，受訪兒童神經發展與住家附近國道面積有顯著負相關，與住家鄰近公園綠地則有正相關。根據本研究的結果，減少空氣污染物排放、增加都巿中的綠地面積，可以增進極低出生體重早產兒的神經發展。

關鍵字

土地利用型態 ； 神經發展 ； 戶外空氣污染 ； 早產 ； 極低出生體重

並列摘要

Air pollution is a global environmental problem and causes numerous adverse health effects. Recent studies indicated that prenatal and perinatal air pollution exposure decreased the neurodevelopment of children. Thus, we conducted a study to evaluate the effects of prenatal and early childhood exposure to air pollution and land use characteristics near residence on neurodevelopment at six months old (adjusted age) among very low birth weight (VLBW) preterm children in the Greater Taipei area. We used geographic information system to estimate air pollution concentrations and land use types around the study children's residences during pregnancy and in the first six months of life. Neurodevelopment of the study children were evaluated using Bayley Scales of Infant and Toddler Development (Bayley-III). Other important information of the children were collected using a structured questionnaire and medical records including prenatal and postnatal residential addresses, basic social demographic characteristics, pollutants at home, etc. We used multiple regressions to examine the relationships of interest. According to the results of regression analyses, several air pollutants (O_3, PM_(10), NO, and NO_2) had adverse effects on children's neurodevelopment. Among different exposure periods, air pollutant exposure during pregnancy had the most significant impact on children's neurodevelopment. In addition, children's neurodevelopment was negatively associated with area of freeways near residence, and positively related to living near parks and greens. Based on the results of this study, reduction of air pollution emission and increase of greenbelts in the urban areas can promote the neurodevelopment of VLBW preterm children.

並列關鍵字

Land Use Types ； Neurodevelopment ； Outdoor Air Pollution ； Preterm Birth ； Very Low Birth Weight