Background

The impact of prenatal ambient air pollution on child asthma may be modified by maternal stress, child sex, and exposure dose and timing.

Objective

We prospectively examined associations between coexposure to prenatal particulate matter with an aerodynamic diameter of less than 2.5 microns (PM_2.5) and maternal stress and childhood asthma (n = 736).

Methods

Daily PM_2.5 exposure during pregnancy was estimated using a validated satellite-based spatiotemporally resolved prediction model. Prenatal maternal negative life events (NLEs) were dichotomized around the median (high: NLE ≥ 3; low: NLE < 3). We used Bayesian distributed lag interaction models to identify sensitive windows for prenatal PM_2.5 exposure on children's asthma by age 6 years, and determine effect modification by maternal stress and child sex.

Results

Bayesian distributed lag interaction models identified a critical window of exposure (19-23 weeks' gestation, cumulative odds ratio, 1.15; 95% CI, 1.03-1.26; per interquartile range [1.7 μg/m³] increase in prenatal PM_2.5 level) during which children concomitantly exposed to prenatal PM_2.5 and maternal stress had increased risk of asthma. No significant association was seen in children born to women reporting low prenatal stress. When examining modifying effects of prenatal stress and fetal sex, we found that boys born to mothers with higher prenatal stress were most vulnerable (19-21 weeks' gestation; cumulative odds ratio, 1.28; 95% CI, 1.15-1.41; per interquartile range increase in PM_2.5).

Conclusions

Prenatal PM_2.5 exposure during sensitive windows is associated with increased risk of child asthma, especially in boys concurrently exposed to elevated maternal stress.

中文翻译：

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产前细颗粒物暴露和儿童早期哮喘：母亲压力和胎儿性别的影响

背景

产前环境空气污染对儿童哮喘的影响可能会因母体压力、儿童性别以及暴露剂量和时间而改变。

客观的

我们前瞻性地研究了同时暴露于空气动力学直径小于 2.5 微米 (PM _2.5 ) 的产前颗粒物与母体压力和儿童哮喘 (n = 736) 之间的关联。

方法

使用经过验证的基于卫星的时空分辨预测模型估计怀孕期间的每日 PM _{2.5暴露量。}产前产妇负面生活事件 (NLE) 围绕中位数进行二分法（高：NLE ≥ 3；低：NLE < 3）。我们使用贝叶斯分布滞后交互模型来确定产前 PM _2.5暴露对 6 岁儿童哮喘的敏感窗口，并确定母体压力和儿童性别的影响修正。

结果

贝叶斯分布滞后相互作用模型确定了一个关键的暴露窗口（妊娠 19-23 周，累积优势比，1.15；95% CI，1.03-1.26；产前 PM _2.5水平每四分位间距 [1.7 μg/m ³ ] 增加）在此期间，同时暴露于产前 PM _2.5和母亲压力的儿童患哮喘的风险增加。在报告产前压力低的妇女所生的孩子中，没有发现显着的相关性。在检查产前压力和胎儿性别的影响时，我们发现产前压力较高的母亲所生的男孩最容易受到伤害（妊娠 19-21 周；累积优势比，1.28；95% CI，1.15-1.41；每四分位距PM _2.5增加）。

结论

在敏感时期暴露于产前 PM _2.5与儿童哮喘风险增加有关，尤其是在同时暴露于母亲压力升高的男孩中。