Association of prenatal exposure to ambient air pollution with adverse birth outcomes and effect modification by socioeconomic factors

Sabah M Quraishi; Marnie F Hazlehurst; Christine T Loftus; Ruby H N Nguyen; Emily S Barrett; Joel D Kaufman; Nicole R Bush; Catherine J Karr; Kaja Z LeWinn; Sheela Sathyanarayana; Frances A Tylavsky; Adam A Szpiro; Daniel A Enquobahrie

doi:10.1016/j.envres.2022.113571

Association of prenatal exposure to ambient air pollution with adverse birth outcomes and effect modification by socioeconomic factors

Environ Res. 2022 Sep;212(Pt E):113571. doi: 10.1016/j.envres.2022.113571. Epub 2022 May 28.

Authors

Affiliations

¹ Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA. Electronic address: sabahq@uw.edu.
² Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
³ Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
⁴ Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
⁵ Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Piscataway, NJ, USA.
⁶ Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Division of General Internal Medicine, School of Medicine, University of Washington, Seattle, WA, USA.
⁷ Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
⁸ Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.
⁹ Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
¹⁰ Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA.
¹¹ Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
¹² Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA.
¹³ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.

Abstract

Background: Maternal exposure to air pollution has been associated with birth outcomes; however, few studies examined biologically critical exposure windows shorter than trimesters or potential effect modifiers.

Objectives: To examine associations of prenatal fine particulate matter (PM_2.5), by trimester and in biologically critical windows, with birth outcomes and assess potential effect modifiers.

Methods: This study used two pregnancy cohorts (CANDLE and TIDES; N = 2099) in the ECHO PATHWAYS Consortium. PM_2.5 was estimated at the maternal residence using a fine-scale spatiotemporal model, averaged over pregnancy, trimesters, and critical windows (0-2 weeks, 10-12 weeks, and last month of pregnancy). Outcomes were preterm birth (PTB, <37 completed weeks of gestation), small-for-gestational-age (SGA), and continuous birthweight. We fit multivariable adjusted linear regression models for birthweight and Poisson regression models (relative risk, RR) for PTB and SGA. Effect modification by socioeconomic factors (maternal education, household income, neighborhood deprivation) and infant sex were examined using interaction terms.

Results: Overall, 9% of births were PTB, 10.4% were SGA, and mean term birthweight was 3268 g (SD = 558.6). There was no association of PM_2.5 concentration with PTB or SGA. Lower birthweight was associated with higher PM_2.5 averaged over pregnancy (β -114.2, 95%CI -183.2, -45.3), during second (β -52.9, 95%CI -94.7, -11.2) and third (β -45.5, 95%CI -85.9, -5.0) trimesters, and the month prior to delivery (β -30.5, 95%CI -57.6, -3.3). Associations of PM_2.5 with likelihood of SGA and lower birthweight were stronger among male infants (p-interaction ≤0.05) and in those with lower household income (p-interaction = 0.09).

Conclusions: Findings from this multi city U.S. birth cohort study support previous reports of inverse associations of birthweight with higher PM_2.5 exposure during pregnancy. Findings also suggest possible modification of this association by infant sex and household income.

Keywords: Air pollution; Birth outcomes; Birthweight; Effect modification; Fine particulate matter; Prenatal exposure; Preterm birth.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
Birth Weight
Cohort Studies
Female
Fetal Growth Retardation
Humans
Infant, Newborn
Male
Maternal Exposure / adverse effects
Particulate Matter / analysis
Particulate Matter / toxicity
Pregnancy
Premature Birth* / chemically induced
Premature Birth* / epidemiology
Prenatal Exposure Delayed Effects* / chemically induced
Socioeconomic Factors

Substances

Air Pollutants
Particulate Matter

Abstract

Publication types

MeSH terms

Substances

Grants and funding