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Chen WJ, Rector AM, Guxens M, Iniguez C, Swartz MD, Symanski E, Ibarluzea J, Ambros A, Estarlich M, Lertxundi A, Riano-Galán I, Sunyer J, Fernandez-Somoano A, Chauhan SP, Ish J, Whitworth KW. Susceptible windows of exposure to fine particulate matter and fetal growth trajectories in the Spanish INMA (INfancia y Medio Ambiente) birth cohort. ENVIRONMENTAL RESEARCH 2023; 216:114628. [PMID: 36279916 PMCID: PMC9847009 DOI: 10.1016/j.envres.2022.114628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
While prior studies report associations between fine particulate matter (PM2.5) exposure and fetal growth, few have explored temporally refined susceptible windows of exposure. We included 2328 women from the Spanish INMA Project from 2003 to 2008. Longitudinal growth curves were constructed for each fetus using ultrasounds from 12, 20, and 34 gestational weeks. Z-scores representing growth trajectories of biparietal diameter, femur length, abdominal circumference (AC), and estimated fetal weight (EFW) during early (0-12 weeks), mid- (12-20 weeks), and late (20-34 weeks) pregnancy were calculated. A spatio-temporal random forest model with back-extrapolation provided weekly PM2.5 exposure estimates for each woman during her pregnancy. Distributed lag non-linear models were implemented within the Bayesian hierarchical framework to identify susceptible windows of exposure for each outcome and cumulative effects [βcum, 95% credible interval (CrI)] were aggregated across adjacent weeks. For comparison, general linear models evaluated associations between PM2.5 averaged across multi-week periods (i.e., weeks 1-11, 12-19, and 20-33) and fetal growth, mutually adjusted for exposure during each period. Results are presented as %change in z-scores per 5 μg/m3 in PM2.5, adjusted for covariates. Weeks 1-6 [βcum = -0.77%, 95%CrI (-1.07%, -0.47%)] were identified as a susceptible window of exposure for reduced late pregnancy EFW while weeks 29-33 were positively associated with this outcome [βcum = 0.42%, 95%CrI (0.20%, 0.64%)]. A similar pattern was observed for AC in late pregnancy. In linear regression models, PM2.5 exposure averaged across weeks 1-11 was associated with reduced late pregnancy EFW and AC; but, positive associations between PM2.5 and EFW or AC trajectories in late pregnancy were not observed. PM2.5 exposures during specific weeks may affect fetal growth differentially across pregnancy and such associations may be missed by averaging exposure across multi-week periods, highlighting the importance of temporally refined exposure estimates when studying the associations of air pollution with fetal growth.
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Affiliation(s)
- Wei-Jen Chen
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alison M Rector
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Monica Guxens
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre (Erasmus MC), Rotterdam, the Netherlands
| | - Carmen Iniguez
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Statistics and Operational Research, Universitat de València, València, Spain; Epidemiology and Environmental Health Joint Research Unit, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Universitat Jaume I-Universitat de València, València, Spain
| | - Michael D Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Elaine Symanski
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
| | - Jesús Ibarluzea
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastian, Spain; Faculty of Psychology, Universidad del País Vasco (UPV/EHU), San Sebastian, Spain
| | - Albert Ambros
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; ISGlobal, Barcelona, Spain
| | - Marisa Estarlich
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Universitat Jaume I-Universitat de València, València, Spain; Faculty of Nursing and Chiropody, Universitat de València, València, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain; Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Isolina Riano-Galán
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Servicio de Pediatría, Endocrinología pediátrica, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Jordi Sunyer
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; ISGlobal, Barcelona, Spain
| | - Ana Fernandez-Somoano
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; IUOPA-Área de Medicina Preventiva y Salud Pública, Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Jennifer Ish
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Durham, NC, USA
| | - Kristina W Whitworth
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
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