Prenatal particulate air pollution exposure and sleep disruption in preschoolers: Windows of susceptibility.

BACKGROUND

The programming of sleep architecture begins in pregnancy and depends upon optimal in utero formation and maturation of the neural connectivity of the brain. Particulate air pollution exposure can disrupt fetal brain development but associations between fine particulate matter (PM) exposure during pregnancy and child sleep outcomes have not been previously explored.

METHODS

Analyses included 397 mother-child pairs enrolled in a pregnancy cohort in Mexico City. Daily ambient prenatal PM exposure was estimated using a validated satellite-based spatio-temporally resolved prediction model. Child sleep periods were estimated objectively using wrist-worn, continuous actigraphy over a 1-week period at age 4-5 years. Data-driven advanced statistical methods (distributed lag models (DLMs)) were employed to identify sensitive windows whereby PM exposure during gestation was significantly associated with changes in sleep duration or efficiency. Models were adjusted for maternal education, season, child's age, sex, and BMI z-score.

RESULTS

Mother's average age was 27.7 years, with 59% having at least a high school education. Children slept an average of 7.7 h at night, with mean 80.1% efficiency. The adjusted DLM identified windows of PM exposure between 31 and 35 weeks gestation that were significantly associated with decreased sleep duration in children. In addition, increased PM during weeks 1-8 was associated with decreased sleep efficiency. In other exposure windows (weeks 39-40), PM was associated with increased sleep duration.

CONCLUSION

Prenatal PM exposure is associated with altered sleep in preschool-aged children in Mexico City. Pollutant exposure during sensitive windows of pregnancy may have critical influence upon sleep programming.