ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Environ Int. 2020 May;138:105619. doi: 10.1016/j.envint.2020.105619. Epub 2020 Mar 16.
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.
We included mother-child pairs (N = 1,724) from the Spanish INMA birth cohort established in 2003-2008. First trimester of pregnancy nitrogen dioxide (NO) and fine particles (PM) 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.
Increased PM 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 PM exposure = -0.12; 95% CI: -0.23, -0.01; zBMI change = -0.12; 95% CI: -0.23, -0.01). Higher NO and PM 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 PM and zWeight and zBMI. PM and NO were not associated with the other cardio-metabolic risk factors.
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.
我们研究了妊娠早期暴露于室外空气污染物与 4 岁时生长和心血管代谢风险之间的关联，并评估了出生体重的中介作用。
我们纳入了 2003-2008 年西班牙 INMA 出生队列中的母婴对子（N=1724）。估计了妊娠早期的二氧化氮（NO）和细颗粒物（PM）暴露水平。在 4 岁时测量了身高、体重、腰围、血压和血脂。确定了从出生到 4 岁的体重指数（BMI）轨迹。
妊娠早期 PM 暴露增加与体重（zWeight）和 BMI（zBMI）的 z 评分降低有关（PM 暴露每四分位距增加时体重 z 评分的变化=-0.12；95%置信区间：-0.23，-0.01；BMI 变化=-0.12；95%置信区间：-0.23，-0.01）。与具有平均 BMI 增长轨迹的儿童相比，较高的 NO 和 PM 暴露与降低处于 BMI 加速增长轨迹的风险相关。出生体重部分中介了 PM 与 zWeight 和 zBMI 之间的关联。PM 和 NO 与其他心血管代谢风险因素无关。
这项对许多与生长和心血管代谢风险相关的结果的综合研究表明，妊娠期间的空气污染暴露可能与出生后早期的身体生长延迟有关。这些发现意味着出生前暴露于空气污染物对出生后生长有持久影响，需要在以后的儿童年龄进行随访。
