Individual and joint effect of indoor air pollution index and ambient particulate matter on fetal growth: a prospective cohort study

Shuang Zhou; Yuming Guo; Tao Su; Gongbo Chen; Hui Liu; Qin Li; Heling Bao; Yuelong Ji; Shusheng Luo; Zheng Liu; Hui Wang; Jue Liu; Na Han; Hai-Jun Wang

doi:10.1093/ije/dyad021

Individual and joint effect of indoor air pollution index and ambient particulate matter on fetal growth: a prospective cohort study

Int J Epidemiol. 2023 Jun 6;52(3):690-702. doi: 10.1093/ije/dyad021.

Authors

Shuang Zhou¹, Yuming Guo², Tao Su³, Gongbo Chen⁴, Hui Liu⁵, Qin Li^{1

6}, Heling Bao¹, Yuelong Ji¹, Shusheng Luo¹, Zheng Liu¹, Hui Wang¹, Jue Liu⁷, Na Han³, Hai-Jun Wang¹

Affiliations

¹ Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
² Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, China.
⁴ Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
⁵ Medical Informatics Center, Peking University, Beijing, China.
⁶ Reproductive Medical Centre, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China.
⁷ Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.

PMID: 36882118
DOI: 10.1093/ije/dyad021

Abstract

Background: Limited studies have examined the effect of prenatal exposure to particulate matter with diameter of <2.5 µm (PM2.5) and <1 μm (PM1) on fetal growth using ultrasound measurements with inconsistent results. No study has evaluated the joint effect of the indoor air pollution index and ambient particulate matter on fetal growth.

Methods: We conducted a prospective birth cohort study in Beijing, China in 2018, including 4319 pregnant women. We estimated prenatal PM2.5 and PM1 exposure using a machine-learning method and calculated the indoor air pollution index based on individual interviews. Gender- and gestational age-adjusted Z-score of the abdominal circumference (AC), head circumference (HC), femur length (FL) and estimated fetal weight (EFW) was calculated and then undergrowth was defined. A generalized estimating equation was used to evaluate the individual and joint effect of indoor air pollution index, PM2.5 and PM1 on fetal Z-score and undergrowth parameters.

Results: One unit increase in the indoor air pollution index was associated with -0.044 (95% CI: -0.087, -0.001) and -0.050 (95% CI: -0.094, -0.006) decrease in the AC and HC Z-scores, respectively. PM1 and PM2.5 were associated with decreased AC, HC, FL and EFW Z-scores, and higher risk of undergrowth. Compared with exposure to lower PM1 (≤ median) and no indoor air pollution, those exposed to higher PM1 (> median) and indoor air pollution had decreased EFW Z-scores (β = -0.152, 95% CI: -0.230, -0.073) and higher risk of EFW undergrowth (RR = 1.651, 95% CI: 1.106, 2.464). Indoor air pollution and ambient PM2.5 exposure had a similar joint effect on the Z-scores and undergrowth parameters of fetal growth.

Conclusions: This study suggested that indoor air pollution and ambient PM exposure had individual and joint negative effects on fetal growth.

Keywords: Air pollution; PM1; PM2.5; fetal growth; indoor; prenatal exposure.

Publication types

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

MeSH terms

Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution, Indoor* / adverse effects
China / epidemiology
Cohort Studies
Environmental Exposure / adverse effects
Female
Fetal Development
Humans
Particulate Matter / adverse effects
Particulate Matter / analysis
Pregnancy
Prospective Studies

Substances

Particulate Matter
Air Pollutants