Prenatal fine particulate exposure and early childhood asthma: effect of maternal stress and fetal gender

Publication date: Available online 8 August 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Alison Lee, Hsiao-Hsien Leon Hsu, Yueh-Hsiu Mathilda Chiu, Sonali Bose, Maria José Rosa, Itai Kloog, Ander Wilson, Joel Schwartz, Sheldon Cohen, Brent A. Coull, Robert O. Wright, Rosalind J. Wright
BackgroundThe impact of prenatal ambient air pollution on child asthma may be modified by maternal stress, child sex and exposure dose and timing.ObjectiveWe prospectively examined associations between co-exposure to prenatal particulate matter with an aerodynamic diameter of less than 2.5 microns (PM2.5) and maternal stress on childhood asthma (n=736).MethodsDaily PM2.5 exposure during pregnancy was estimated using a validated satellite-based spatio-temporally resolved prediction model. Prenatal maternal negative life events (NLEs) were dichotomized around the median (high: NLE≥3; low: NLE<3). We employed Bayesian distributed lag interaction models (BDLIMs) to identify sensitive windows for prenatal PM2.5 exposure on children's asthma by age 6, and determine effect modification by maternal stress and child sex.ResultsBDLIMs identified a critical window of exposure (19-23 weeks gestation, cumulative OR=1.15, 95%CI=1.03-1.26; per IQR (1.7 μg/m³) increase in prenatal PM2.5 level) during which children concomitantly exposed to prenatal PM2.5 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 OR=1.28, 95%CI=1.15-1.41; per IQR increase in PM2.5).ConclusionPrenatal PM2.5 exposure during sensitive windows is associated with increased risk of child asthma, especially in boys concurrently exposed to elevated maternal stress.

Teaser

These analyses demonstrate that concomitant exposure to prenatal PM2.5 and maternal stress is associated with increased risk of asthma, especially in boys.


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