No abstract

Background: A growing body of evidence has associated maternal exposure to air pollution with adverse effects on fetal growth; however, the existing literature is inconsistent.Objectives: We aimed to quantify the association between maternal exposure to particulate air pollution and term birth weight and low birth weight (LBW) across 14 centers from 9 countries, and to explore the influence of site characteristics and exposure assessment methods on between-center heterogeneity in this association.Methods: Using a common analytical protocol, International Collaboration on Air Pollution and Pregnancy Outcomes (ICAPPO) centers generated effect estimates for term LBW and continuous birth weight associated with PM10 and PM2.5 (particulate matter ≤ 10 and 2.5 µm). We used meta-analysis to combine the estimates of effect across centers (~ 3 million births) and used meta-regression to evaluate the influence of center characteristics and exposure assessment methods on between-center heterogeneity in reported effect estimates.Results: In random-effects meta-analyses, term LBW was positively associated with a 10-μg/m3 increase in PM10 [odds ratio (OR) = 1.03; 95% CI: 1.01, 1.05] and PM2.5 (OR = 1.10; 95% CI: 1.03, 1.18) exposure during the entire pregnancy, adjusted for maternal socioeconomic status. A 10-μg/m3 increase in PM10 exposure was also negatively associated with term birth weight as a continuous outcome in the fully adjusted random-effects meta-analyses (–8.9 g; 95% CI: –13.2, –4.6 g). Meta-regressions revealed that centers with higher median PM2.5 levels and PM2.5:PM10 ratios, and centers that used a temporal exposure assessment (compared with spatiotemporal), tended to report stronger associations.Conclusion: Maternal exposure to particulate pollution was associated with LBW at term across study populations. We detected three site characteristics and aspects of exposure assessment methodology that appeared to contribute to the variation in associations reported by centers.

We developed a novel food-based diet score for preschool children that could be applied in future studies to compare diet quality in early childhood and to investigate associations between diet in early childhood and growth, health, and development.

Suboptimal vitamin D status is common among 6-y-old children in The Netherlands, especially among non-Western children and in winter and spring. Important modifiable factors associated with vitamin D deficiency were overall diet quality, sedentary behavior, and playing outside.

Abstract-Exposure to air pollution is associated with elevated blood pressure and cardiovascular disease. We assessed the associations of exposure to particulate matter (PM 10 ) and nitrogen dioxide (NO 2 ) levels with blood pressure measured in each trimester of pregnancy and the risks of pregnancy-induced hypertension and preeclampsia in 7006 women participating in a prospective cohort study in the Netherlands. Information on gestational hypertensive disorders was obtained from medical records. PM 10 exposure was not associated with first trimester systolic and diastolic blood pressure, but a 10-g/m 3 increase in PM 10 levels was associated with a 1.11-mm Hg (95% confidence interval [CI] 0.43 to 1.79) and 2.11-mm Hg (95% CI 1.34 to 2.89) increase in systolic blood pressure in the second and third trimester, respectively. Longitudinal analyses showed that elevated PM 10 exposure levels were associated with a steeper increase in systolic blood pressure throughout pregnancy (PϽ0.01), but not with diastolic blood pressure patterns. Elevated NO 2 exposure was associated with higher systolic blood pressure levels in the first, second, and third trimester (PϽ0.05), and with a more gradual increase when analyzed longitudinally (PϽ0.01). PM 10 exposure, but not NO 2 exposure, was associated with an increased risk of pregnancy-induced hypertension (odds ratio 1.72 [95% CI 1.12 to 2.63] per 10-g/m 3 increase). In conclusion, our results suggest that air pollution may affect maternal cardiovascular health during pregnancy. The effects might be small but relevant on a population level. Key Words: air pollution Ⅲ pregnancy Ⅲ blood pressure Ⅲ hypertension Ⅲ preeclampsia A ir pollution exposure has been associated with cardiovascular morbidity and mortality. 1-3 Several potential mechanisms for this association have been proposed, including alterations in the autonomic nervous system, induction of pulmonary and systemic inflammation and oxidative stress, endothelial dysfunction, and increased blood coagulability. 1,2,4,5 Elevated blood pressure is a known risk factor for cardiovascular disease and may be implicated in the association between air pollution and cardiovascular morbidity and mortality. Although results differ among studies, 6 -18 there is increasing evidence for a relationship between air pollution exposure and elevated blood pressure levels. 19 Pregnant women are a susceptible group for hypertensive disorders, since changes in pregnancy lead to increased stress on the cardiovascular system. 20 A few previous studies observed higher risks of preeclampsia following exposure to air pollution. [21][22][23] However, the associations of air pollution exposure with blood pressure patterns during pregnancy and pregnancy-induced hypertension have not yet been examined.We investigated the associations of particulate matter (PM 10 ) and nitrogen dioxide (NO 2 ) exposure levels during pregnancy with repeatedly measured blood pressure and the risks of pregnancy-induced hypertension and preeclampsia in a population-based co...