BIRTH WEIGHT, HEAD CIRCUMFERENCE AND EXPOSURE TO AMBIENT AIR POLLUTION DURING PREGNANCY: A EUROPEAN COHORT STUDY (ESCAPE)

摘要

Background: Adverse effects of ambient air pollution on foetal growth have been reported, but findings are inconsistent. Aims: We evaluated the impacts of exposure to traffic-related air pollution during pregnancy on newborn size using standardized exposure assessment taking into account fine-scale spatial and temporal contrasts. Methods: We harmonised and pooled data on 74,000 singleton births (1994-2011) from 14 cohorts in 12 European countries, and applied the same protocol within the European Study of Cohorts for Air Pollution Effects (ESCAPE). Ambient nitrogen dioxide (NO2), nitrogen oxides (NOX), particulate matter (PM10, PM2.5), PM2.5-10 and PM2.5 absorbance (soot) concentrations at the home addresses during pregnancy were estimated using temporally adjusted land-use regression models. Linear and logistic regressions were used to estimate associations. Results: Pregnancy mean exposure (μg/m3) was 26.2 for NO2 (5-95th percentiles: 11.7-45.8), 25.4 (11.6 -39.1) for PM10 and 16.5 (8.8-24.9) for PM2.5. Pregnancy mean exposure to PM2.5 was associated with an increased odds of 1.18 (1.06,1.33) for term low birth weight (＜2,500 g among births after 37 weeks of gestation), a decrease by -10 (-19, -1) g in mean birth weight, and -0.08 (-0.12, -0.03) cm in mean head circumference per 5μg/m3 increment in PM2.5 after adjustment for individual information on potential confounders. A 10-μg/m3 increase in NO2 and PM10 were associated with an increased risk of term low birth weight (1.09 (1.00,1.19) and 1.16 (1.00,1.35)). Reductions in head circumference were also observed for the other pollutants. Conclusions: In this large European cohort study using standardized exposure assessment maternal exposure to ambient air pollution from traffic emissions during pregnancy was associated with reduced foetal growth. Risk estimates are higher than those of previous meta-analyses based on different or less harmonized exposure metrics.