Twin growth discordance in association with maternal exposure to fine particulate matter and its chemical constituents during late pregnancy

Ping Qiao; Yan Zhao; Jing Cai; Aaron van Donkelaar; Randall Martin; Hao Ying; Haidong Kan

doi:10.1016/j.envint.2019.105148

Twin growth discordance in association with maternal exposure to fine particulate matter and its chemical constituents during late pregnancy

Environ Int. 2019 Dec;133(Pt A):105148. doi: 10.1016/j.envint.2019.105148. Epub 2019 Sep 10.

Authors

Ping Qiao¹, Yan Zhao¹, Jing Cai², Aaron van Donkelaar³, Randall Martin³, Hao Ying⁴, Haidong Kan⁵

Affiliations

¹ Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
² School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
³ Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada.
⁴ Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China. Electronic address: stephenying_2011@163.com.
⁵ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China. Electronic address: kanh@fudan.edu.cn.

PMID: 31518941
DOI: 10.1016/j.envint.2019.105148

Abstract

Background: Twin growth discordance is one of the leading causes of perinatal mortality in twin pregnancies. Whether prenatal exposure to fine particle (PM_2.5) air pollution is associated with twin growth discordance have not been studied yet.

Objective: To evaluate the associations of prenatal exposure to PM_2.5 and its chemical constituents with twin growth discordance.

Methods: This study included 1917 twin pairs and their mothers drawn from a previous twin birth cohort at the Shanghai First Maternity and Infant hospital in Shanghai, China. Exposure to PM_2.5 total mass and 6 key chemical constituents during the whole pregnancy and each trimester of pregnancy was represented by satellite-based models.

Results: Maternal exposures to PM_2.5 total mass and chemical constituents of sulfate (SO₄^2-) and ammonium (NH₄⁺) during the third trimester were significantly associated with increased within-pair birth weight difference and intertwin birth weight discordance. The within-pair birth weight difference increased by 30.6 g (β = 30.6, 95% CI, 4.4-56.9), 19.2 g (β = 19.2, 95% CI, 0.2-38.1) and 33.2 g (β = 33.2, 95% CI, 7.9-58.6) for an IQR increase in PM_2.5 total mass, SO₄^2- and NH₄⁺ exposure, respectively. While the intertwin birth weight discordance increased by 1.3% (β = 1.3, 95% CI, 0.3-2.2), 0.9% (β = 0.9, 95% CI, 0.2-1.6) and 1.4% (β = 1.4, 95% CI, 0.4-2.3) for the same exposure metrics. Moreover, higher SO₄^2- and NH₄⁺ exposure was also associated with increased risk of twin growth discordance in linear dose-response manners. Compared to the lowest quartile of SO₄^2- (OR = 2.51, 95% CI, 1.08-5.82) and NH₄⁺ (OR = 2.97, 95% CI, 1.16-7.58) exposure, the odds of twin growth discordance were doubled in highest quartile of exposure.

Conclusion: Our results suggest that fine particle air pollution may be a risk factor for twin growth discordance. Late pregnancy seems to be a critical window for the effects of PM_2.5 exposure on fetal growth in twins.

Keywords: Ambient air pollution; Chemical constituents; PM(2.5); Twin growth discordance; Within-pair birth weight difference.

Publication types

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

MeSH terms

Air Pollutants / chemistry*
Air Pollutants / toxicity*
Birth Weight / physiology
China
Female
Fetal Development / drug effects*
Humans
Infant, Newborn
Maternal Exposure*
Particulate Matter / chemistry*
Pregnancy
Pregnancy Trimester, Third*
Twins*

Substances

Air Pollutants
Particulate Matter