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. 2021 May 28;18(11):5806.
doi: 10.3390/ijerph18115806.

Maternal Ambient Exposure to Atmospheric Pollutants during Pregnancy and Offspring Term Birth Weight in the Nationwide ELFE Cohort

Marion Ouidir  1   2 , Emie Seyve  1 , Emmanuel Rivière  3 , Julien Bernard  3 , Marie Cheminat  4 , Jérôme Cortinovis  5 , François Ducroz  6 , Fabrice Dugay  7 , Agnès Hulin  8 , Itai Kloog  9 , Anne Laborie  10 , Ludivine Launay  11 , Laure Malherbe  12 , Pierre-Yves Robic  13 , Joel Schwartz  14 , Valérie Siroux  1 , Jonathan Virga  15 , Cécile Zaros  4 , Marie-Aline Charles  4   16 , Rémy Slama  1 , Johanna Lepeule  1
Affiliations

Maternal Ambient Exposure to Atmospheric Pollutants during Pregnancy and Offspring Term Birth Weight in the Nationwide ELFE Cohort

Marion Ouidir et al. Int J Environ Res Public Health. .

Abstract

Background: Studies have reported associations between maternal exposure to atmospheric pollution and lower birth weight. However, the evidence is not consistent and uncertainties remain. We used advanced statistical approaches to robustly estimate the association of atmospheric pollutant exposure during specific pregnancy time windows with term birth weight (TBW) in a nationwide study.

Methods: Among 13,334 women from the French Longitudinal Study of Children (ELFE) cohort, exposures to PM2.5, PM10 (particles < 2.5 µm and <10 µm) and NO2 (nitrogen dioxide) were estimated using a fine spatio-temporal exposure model. We used inverse probability scores and doubly robust methods in generalized additive models accounting for spatial autocorrelation to study the association of such exposures with TBW.

Results: First trimester exposures were associated with an increased TBW. Second trimester exposures were associated with a decreased TBW by 17.1 g (95% CI, -26.8, -7.3) and by 18.0 g (-26.6, -9.4) for each 5 µg/m3 increase in PM2.5 and PM10, respectively, and by 15.9 g (-27.6, -4.2) for each 10 µg/m3 increase in NO2. Third trimester exposures (truncated at 37 gestational weeks) were associated with a decreased TBW by 48.1 g (-58.1, -38.0) for PM2.5, 38.1 g (-46.7, -29.6) for PM10 and 14.7 g (-25.3, -4.0) for NO2. Effects of pollutants on TBW were larger in rural areas.

Conclusions: Our results support an adverse effect of air pollutant exposure on TBW. We highlighted a larger effect of air pollutants on TBW among women living in rural areas compared to women living in urban areas.

Keywords: air pollution; doubly robust; propensity score; spatial autocorrelation; term birth weight.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Association between atmospheric pollutant exposure during pregnancy and term birth weight (n = 13,334 pregnant women from ELFE cohort). All effect estimates correspond to an increase of 5 µg/m3 for PM2.5 and PM10 and 10 µg/m3 for NO2. Regression coefficients are from weighted generalized additive models1. Full weights are represented in black and trimmed weights in grey. The symbol reflects the central estimate, the line represents the 95% confidence interval. 1 using the stabilized inverse probability of being exposed to air pollutants calculated using maternal education, relationship status, parity, sex of the child, maternal active smoking during pregnancy, social deprivation, maternal French citizenship, maternal age, weight before pregnancy and maternal height, and further adjusted for urbanization level and season of conception. * exposure truncated at 37 gestational weeks.
Figure 2
Figure 2
Adjusted difference in mean term birth weight (g) associated with atmospheric pollutant exposures during pregnancy using the doubly robust method (n = 13,334 pregnant women from ELFE cohort). All effect estimates correspond to an increase of 5 µg/m3 for PM2.5 and PM10 and 10 µg/m3 for NO2. Regression coefficients are from weighted doubly robust generalized additive models 1. Estimates corresponding to models with full weights (in black) and trimmed weights (in grey) are represented. The point shows the central estimate, the line represents the 95% confidence interval. 1 using the stabilized inverse probability of being exposed to air pollutants calculated using maternal education, in relationship status, parity, sex of the child, maternal active smoking during pregnancy, social deprivation, maternal French citizenship, maternal age, weight before pregnancy and maternal height, and further adjusted for the aforementioned covariates plus urbanization level and season of conception. * exposure truncated at 37 gestational weeks.
Figure 3
Figure 3
Adjusted difference in mean term birth weight (g) associated with atmospheric pollutant exposures during pregnancy (n = 13,334 pregnant women from ELFE cohort) accounting for the correlation among trimesters of pregnancy. All effect estimates correspond to an increase of 5 µg/m3 for PM2.5 and PM10 and 10 µg/m3 for NO2. Regression coefficients are from weighted doubly robust generalized additive models 1. Estimates corresponding to models with full weights (in black) and trimmed weights (in grey) are represented. The point shows the central estimate, the line represents the 95% confidence interval. 1 using the stabilized inverse probability of being exposed to air pollutants calculated using maternal education, in relationship status, parity, sex of the child, maternal active smoking during pregnancy, social deprivation, maternal French citizenship, maternal age, weight before pregnancy and maternal height, and further adjusted for the aforementioned covariates plus urbanization level, season of conception and residuals of the regression between trimesters. * exposure truncated at 37 gestational weeks.
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