Air pollution exposure during pregnancy and childhood cognitive and psychomotor development in 6 European birth cohort studies. The ESCAPE Project

摘要

Background: Accumulating evidence from experimental studies suggests that air pollution may have an impact on the development of the central nervous system. Aims: To assess whether air pollution exposure during pregnancy affects cognitive and psychomotor development in childhood. Methods: Collaborative study of 6 European population-based birth cohorts (GENERATION R (The Netherlands), DUISBURG (Germany), EDEN (France, 2 areas), GASPII (Italy), RHEA (Greece), and INMA (Spain, 5 areas)). Mother-child pairs were recruited from 1997 to 2008. Air pollution levels (nitrogen oxides (NO2, NOx), particulate matter with diameters of less than 2.5μm (PM2.5), less than 10μm (PM10), and 2.5-10μm (PMcoarse), and PM2.5 absorbance) at birth addresses were estimated by land-use regression models based on monitoring campaigns mostly performed between 2008 and 2011. Levels were extrapolated back in time to exact pregnancy periods using routine background monitoring network sites. General cognition, language, and psychomotor development were assessed between 1 and 6 years of age. Adjusted area-specific effect estimates were combined using random-effects meta-analysis. Results: A total of 9,482 children were included. Air pollution exposure during pregnancy was negatively associated with psychomotor development. Decreases of global psychomotor development score by 0.62 points (95% Confidence Interval -1.16; -0.09) and 1.66 points (95% Confidence Interval -3.49; 0.16) were found per each increase by 10μg/m3 in NO2 and by 5μg/m3 in PM2.5 pregnancy levels, respectively. Similar trends were observed in most areas. No association was found between air pollution exposure during pregnancy and general cognition or language development. Conclusions: Air pollution exposure during pregnancy was associated with delayed psychomotor development during childhood. Follow-up at older ages should explore catch-up and whether air pollution is related to cognitive development beyond psychomotor development.