Cumulative exposure to environmental pollutants during early pregnancy and reduced fetal growth: the Project Viva cohort

Abstract

BackgroundReduced fetal growth is associated with perinatal and later morbidity. Prenatal exposure to environmental pollutants is linked to reduced fetal growth at birth, but the impact of concomitant exposure to multiple pollutants is unclear. The purpose of this study was to examine interactions between early pregnancy exposure to cigarette smoke, traffic pollution, and select perfluoroalkyl substances (PFASs) on birth weight-for-gestational age (BW/GA).MethodsAmong 1597 Project Viva mother-infant pairs, we assessed maternal cigarette smoking by questionnaire, traffic pollution at residential address by black carbon land use regression model, and plasma concentration of select PFASs in early pregnancy. We calculated sex-specific BW/GA z-scores, an index of fetal growth, from national reference data. We fit covariate-adjusted multi-pollutant linear regression models and examined interactions between exposures, using a likelihood-ratio test to identify a best-fit model.ResultsTwo hundred six (13%) mothers smoked during pregnancy. Mean [standard deviation (SD)] for black carbon was 0.8 (0.3) μg/m3, perfluorooctane sulfonate (PFOS) was 29.1 (16.5) ng/mL, and BW/GA z-score was 0.19 (0.96). In the best-fit model, BW/GA z-score was lower in infants of mothers exposed to greater black carbon [− 0.08 (95% CI: -0.15, − 0.01) per interquartile range (IQR)]. BW/GA z-score (95% CI) was also lower in infants of mothers who smoked [− 0.09 (− 0.23, 0.06)] or were exposed to greater PFOS [− 0.03 (− 0.07, 0.02) per IQR], although confidence intervals crossed the null. There were no interactions between exposures. In secondary analyses, instead of PFOS, we examined perfluorononanoate (PFNA) [mean (SD): 0.7 (0.4) ng/mL], a PFAS more closely linked to lower BW/GA in our cohort. The best-fit multi-pollutant model included positive two-way interactions between PFNA and both black carbon and smoking (p-interactions = 0.03).ConclusionsConcurrent prenatal exposures to maternal smoking, black carbon, and PFOS are additively associated with lower fetal growth, whereas PFNA may attenuate associations of smoking and black carbon with lower fetal growth. It is important to examine interactions between multiple exposures in relation to health outcomes, as effects may not always be additive and may shed light on biological pathways.Electronic supplementary materialThe online version of this article (10.1186/s12940-018-0363-4) contains supplementary material, which is available to authorized users.

Association Between Exposure to Per- and Polyfluoroalkyl Substances and Birth Outcomes: A Systematic Review and Meta-Analysis

“…After excluding duplicates, we retained a total of 918 papers for title/abstract screening. As shown in Figure 1 , we conducted a full-text search of 58 relevant articles, of which 46 provided available data on PFAS and birth outcomes that could be pooled for meta-analysis as well as evaluation ( 12 – 14 , 20 , 29 , 36 – 39 , 41 , 43 – 46 , 57 , 60 – 68 , 71 , 76 – 95 ). Among them, 2 publications ( 96 , 97 ) examined the association between PFAS and reproductive distance, while 3 articles ( 98 – 100 ) focused on the association between PFAS exposure in the environment and birth outcomes.…”

“…The World Health Organization (WHO) estimated that children under 5 years of age bear more than 40% of the burden of environment-related diseases despite accounting for only 10% of the global population ( 12 – 14 ). Air pollution has been extensively studied as a direct cause of child health problems, such as adverse birth outcomes, impaired cognitive and behavioral development ( 15 – 17 ), and respiratory diseases ( 18 , 19 ).…”

Co-methylation analysis in lung tissue identifies pathways for fetal origins of COPD

“…Maternal smoking during pregnancy is prevalent, at 14-26% in the US population [11][12][13] and 10-35% worldwide [12,14]. This poses severe risks to the developing fetus and fetal lung [15], including intrauterine growth abnormalities [16,17], pre-term birth [18], low birthweight [19] and altered immune responses [20,21]. DNA methylation has been suggested as a potential mediator between maternal smoking and low birthweight [22].…”

Exposure to night‐time light pollution and risk of prolonged duration of labor: A nationwide cohort study

“…However, the available literature suggests that the full impact of LP on human health is not yet known, and many studies are still to be conducted. Importantly, future research should assess the complex mixture of environmental pollutants (eg, air/noise/water pollution, urban heat islands) in relation to adverse health outcomes, since some authors suggest that simultaneous exposure effects may not always be additive, but interactive 43 . In this context, studies have focused on fetal growth, birthweight, and prematurity; analyses of other outcomes are missing to date 44 .…”