Background & aims

Prenatal exposure to air pollution is robustly associated with fetal growth restriction but the extent to which it is associated with postnatal growth and the risk of childhood obesity remains unknown. We examined the association of prenatal exposure to air pollution with offspring obesity related measures and evaluated the possible protective effect of maternal fruits and vegetables intake (FV).

Methods

We included 633 mother-child pairs from the Rhea pregnancy cohort in Crete, Greece. Fine particles (PM_2.5 and PM₁₀) exposure levels during pregnancy were estimated using land-use regression models. We measured weight, height and waist circumference at 4 and 6 years of age, and body composition analysis was performed at 6 years using bioimpedance. Maternal diet was evaluated by means of a semi-quantitative food frequency questionnaire in mid-pregnancy. Adjusted associations were obtained via multivariable regression analyses and multiplicative interaction was used to evaluate the potential modifying role of FV intake.

Results

Exposure to PMs in utero was not associated with measures of adiposity at 4 or 6 years of age. Associations at 4 years did not differ according to maternal consumption of FV. However, at 6 years, among children whose mothers reported consuming less than 5 servings of FV per day, one SD increase in PM₁₀ during pregnancy was associated with increased BMI (beta 0.41 kg/m², 95% CI: −0.06, 0.88, p-interaction = 0.037) and increased waist circumference (beta 0.83 cm, 95% CI: −0.38, 2.05, p-interaction = 0.043) and one SD increase in PM_2.5 was associated with increased fat mass (beta 0.5 kg, 95% CI: 0.0, 0.99, p-interaction = 0.039) and increased percentage of body fat (beta 1.06%, 95% CI: −0.06, 2.17, p-interaction = 0.035). Similarly, higher prenatal PM_2.5 and PM₁₀ exposure was associated with increased risk for obesity and abdominal obesity at 6 years only in the low FV group.

Conclusions

Exposure to fine particulate matter during pregnancy was not associated with obesity-related measures at 4 and 6 years. However, only among offspring of mothers who consumed inadequate FV, we observed higher obesity-related measures at 6 years. Our results indicate that mothers' diet during pregnancy may play a role in the relationship between air-pollution and childhood obesity.

中文翻译：

---

产前空气污染暴露与儿童肥胖：母亲水果和蔬菜摄入量的影响

背景和目标

产前暴露于空气污染与胎儿生长受限密切相关，但其与产后生长和儿童肥胖风险的相关程度仍不清楚。我们研究了产前空气污染暴露与后代肥胖相关措施的关联，并评估了母亲水果和蔬菜摄入量（FV）可能的保护作用。

方法

我们纳入了来自希腊克里特岛瑞亚怀孕队列的 633 对母子。使用土地利用回归模型估算了怀孕期间的细颗粒物（PM _2.5和 PM _{10 ）暴露水平。}我们测量了 4 岁和 6 岁时的体重、身高和腰围，并在 6 岁时使用生物阻抗进行了身体成分分析。通过妊娠中期半定量食物频率调查问卷评估母亲饮食。通过多变量回归分析获得调整后的关联，并使用乘法交互作用来评估 FV 摄入量的潜在改变作用。

结果

子宫内接触 PM 与 4 岁或 6 岁时的肥胖程度无关。4 岁时的相关性并没有因母亲摄入 FV 的不同而有所不同。然而，在 6 岁时，在母亲报告每天摄入少于 5 份 FV 的儿童中，怀孕期间 PM _{10的 SD 增加 1 个，}与 BMI 增加相关（β 0.41 kg/m ²，95% CI：-0.06，0.88 ，p 交互作用 = 0.037）和腰围增加（β 0.83 cm，95% CI：-0.38, 2.05，p 交互作用 = 0.043）以及 PM _2.5的一个 SD 增加与脂肪量增加相关（β 0.5 kg，95 % CI：0.0, 0.99，p 交互作用 = 0.039），体脂百分比增加（β 1.06%，95% CI：-0.06, 2.17，p 交互作用 = 0.035）。同样，仅在低 FV 组中，较高的产前 PM _2.5和 PM ₁₀暴露与 6 岁时肥胖和腹部肥胖的风险增加相关。

结论

怀孕期间接触细颗粒物与 4 岁和 6 岁时的肥胖相关指标无关。然而，只有在摄入 FV 不足的母亲的后代中，我们在 6 岁时观察到了更高的肥胖相关指标。我们的研究结果表明，母亲在怀孕期间的饮食可能在空气污染和儿童肥胖之间的关系中发挥作用。