Serena Fossati1, Damaskini Valvi2, David Martinez3, Marta Cirach3, Marisa Estarlich4, Ana Fernández-Somoano5, Mònica Guxens6, Carmen Iñiguez7, Amaia Irizar8, Aitana Lertxundi9, Mark Nieuwenhuijsen3, Ibon Tamayo10, Jesus Vioque11, Adonina Tardón5, Jordi Sunyer3, Martine Vrijheid3. 1. ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain. Electronic address: serena.fossati@isglobal.org. 2. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States. 3. ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain. 4. CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Nursing, Faculty of Nursing and Chiropody, University of Valencia; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, 46020, Spain. 5. CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IUOPA-Departamento de Medicina, University of Oviedo, Oviedo, Spain; Institute of Health Research of the Principality of Asturias - Foundation for Biosanitary Research of Asturias (ISPA-FINBA), Oviedo, Spain. 6. ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands. 7. CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Statistics and Computational Research, Universitat de València, Valencia, Spain. 8. Biodonostia Health Research Institute, Donostia, Spain. 9. CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Biodonostia Health Research Institute, Donostia, Spain; Faculty of Medicine and Nursing of the University of the Basque Country, Bilbao, Spain. 10. ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Division of Immunology and Immunotherapy, Cima, Universidad de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdISNA), Pamplona, Spain. 11. CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Universidad Miguel Hernandez, ISABIAL-FISABIO, Alicante, Spain.
Abstract
OBJECTIVES: We investigated the association between outdoor air pollutants exposure in the first trimester of pregnancy, and growth and cardio-metabolic risk at four years of age, and evaluated the mediating role of birth weight. METHODS: We included mother-child pairs (N = 1,724) from the Spanish INMA birth cohort established in 2003-2008. First trimester of pregnancy nitrogen dioxide (NO2) and fine particles (PM2.5) exposure levels were estimated. Height, weight, waist circumference, blood pressure, and lipids were measured at four years of age. Body mass index (BMI) trajectories from birth to four years were identified. RESULTS: Increased PM2.5 exposure in the first trimester of pregnancy was associated with decreased z-scores of weight (zWeight) and BMI (zBMI) (zWeight change per interquartile range increase in PM2.5 exposure = -0.12; 95% CI: -0.23, -0.01; zBMI change = -0.12; 95% CI: -0.23, -0.01). Higher NO2 and PM2.5 exposure was associated to a reduced risk of being in a trajectory with accelerated BMI gain, compared to children with the average trajectory. Birth weight partially mediated the association between PM2.5 and zWeight and zBMI. PM2.5 and NO2 were not associated with the other cardio-metabolic risk factors. CONCLUSIONS: This comprehensive study of many growth and cardio-metabolic risk related outcomes suggests that air pollution exposure during pregnancy may be associated with delays in physical growth in the early years after birth. These findings imply that pregnancy exposure to air pollutants has a lasting effect on growth after birth and require follow-up at later child ages.
OBJECTIVES: We investigated the association between outdoor air pollutants exposure in the first trimester of pregnancy, and growth and cardio-metabolic risk at four years of age, and evaluated the mediating role of birth weight. METHODS: We included mother-child pairs (N = 1,724) from the Spanish INMA birth cohort established in 2003-2008. First trimester of pregnancy nitrogen dioxide (NO2) and fine particles (PM2.5) exposure levels were estimated. Height, weight, waist circumference, blood pressure, and lipids were measured at four years of age. Body mass index (BMI) trajectories from birth to four years were identified. RESULTS: Increased PM2.5 exposure in the first trimester of pregnancy was associated with decreased z-scores of weight (zWeight) and BMI (zBMI) (zWeight change per interquartile range increase in PM2.5 exposure = -0.12; 95% CI: -0.23, -0.01; zBMI change = -0.12; 95% CI: -0.23, -0.01). Higher NO2 and PM2.5 exposure was associated to a reduced risk of being in a trajectory with accelerated BMI gain, compared to children with the average trajectory. Birth weight partially mediated the association between PM2.5 and zWeight and zBMI. PM2.5 and NO2 were not associated with the other cardio-metabolic risk factors. CONCLUSIONS: This comprehensive study of many growth and cardio-metabolic risk related outcomes suggests that air pollution exposure during pregnancy may be associated with delays in physical growth in the early years after birth. These findings imply that pregnancy exposure to air pollutants has a lasting effect on growth after birth and require follow-up at later child ages.
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