Association of Maternal Exposure to Fine Particulate Matter During Pregnancy with Anterior Segment Dysgenesis Risk: A Matched Case-Control Study.

To assess the association of residential-level maternal particulate matter of 2.5 μm diameter or less (PM) exposure during pregnancy with anterior segment dysgenesis (ASD) risk. This study used data from children diagnosed with ASD (i.e., aniridia, iris hypoplasia, Peters anomaly, Axenfeld-Rieger syndrome, or primary congenital glaucoma) by an experienced pediatric ophthalmologist at a National Referral Center for Rare Diseases between 2004 and 2021 and their biological mothers. Individual PM exposure concentration was assessed by reference to residential addresses and district-specific PM concentrations predicted by the universal Kriging prediction model. The study included 2328 children (582 ASD cases and 1746 controls [1:3 matched for birth year, sex, and birth-place]). The mean (SD) annual PM exposure was 29.2 (16.9) μg/m. An IQR increase in PM during the preconception period (11.6 μg/m; RR, 1.18; 95% CI, 1.03-1.34), the 1st trimester (11.1 μg/m; RR, 1.15; 95% CI, 1.03-1.27), and the 2nd trimester (11.2 μg/m; RR 1.14; 95% CI, 1.01-1.29) significantly increased ASD risk. Meanwhile, the association between IQR increase in PM during the 3rd trimester and ASD risk showed borderline significance (11.0 μg/m; RR, 1.10; 95% CI, 0.99-1.21). An IQR increase in PM (6.9 μg/m) from the preconception period to the 3rd trimester was associated with a significantly increased risk of ASD (RR, 1.13; 95% CI, 1.08-1.20). The findings of this study suggest that PM exposure during the preconception period and pregnancy is associated with increased risk of ASD, supporting a need for further improvements in air quality to prevent congenital ocular anomalies.