Preconceptional and prenatal exposure to air pollution increases incidence of childhood pneumonia: A hypothesis of the (pre-)fetal origin of childhood pneumonia

Lu, Chan; Wang, Peng; Kuang, Jian; Wu, Maolan; Wu, Haiyu; Murithi, Rachael Gakii; Johnson, McSherry Brownel; Zheng, Xiangrong

doi:10.1016/j.ecoenv.2020.111860

Cited by 14 publications

(9 citation statements)

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“…Similarly, a case-control study from China showed a positive, significant association between prenatal exposure to SO 2 and pneumonia during 0–14 years of age. 34 In contrast, the evidence on prenatal exposure to NO 2 and the risk of LRTIs has been weak. 33 35 Further longitudinal studies are still important to strengthen the hypothesis that prenatal air pollution exposure increases the risk of early childhood respiratory infections.…”

Section: Discussionmentioning

confidence: 99%

Prenatal and early life exposure to air pollution and the risk of severe lower respiratory tract infections during early childhood: the Espoo Cohort Study

Belachew,

Rantala,

Jaakkola

et al. 2024

Occup Environ Med

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BackgroundThere is inconsistent evidence of the effects of exposure to ambient air pollution on the occurrence of lower respiratory tract infections (LRTIs) in early childhood. We assessed the effects of individual-level prenatal and early life exposure to air pollutants on the risk of LRTIs in early life.MethodsWe studied 2568 members of the population-based Espoo Cohort Study born between 1984 and 1990 and living in 1991 in the City of Espoo, Finland. Exposure assessment was based on dispersion modelling and land-use regression for lifetime residential addresses. The outcome was a LRTI based on data from hospital registers. We applied Poisson regression to estimate the incidence rate ratio (IRR) of LTRIs, contrasting incidence rates in the exposure quartiles to the incidence rates in the first quartile. We used weighted quantile sum (WQS) regression to estimate the joint effect of the studied air pollutants.ResultsThe risk of LRTIs during the first 2 years of life was significantly related to exposure to individual and multiple air pollutants, measured with the Multipollutant Index (MPI), including primarily sulphur dioxide (SO2), particulate matter with a dry diameter of up to 2.5 µm (PM2.5) and nitrogen dioxide (NO2) exposures in the first year of life, with an adjusted IRR of 1.72 per unit increase in MPI (95% CI 1.20 to 2.47). LRTIs were not related to prenatal exposure.ConclusionsWe provide evidence that ambient air pollution exposure during the first year of life increases the risk of LRTIs during the first 2 years of life. SO2, PM2.5and NO2were found to contribute the highest weights on health effects.

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Section: Discussionmentioning

confidence: 99%

Prenatal and early life exposure to air pollution and the risk of severe lower respiratory tract infections during early childhood: the Espoo Cohort Study

Belachew,

Rantala,

Jaakkola

et al. 2024

Occup Environ Med

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“…Variables such as sex and postnatal environment can worsen health outcomes. For example, the risk of pneumonia in children with a history of preconception and prenatal exposure to SO 2 was higher in boys living in high temperatures [51].…”

Section: Direct Prenatal Exposures and Respiratory Health Outcomesmentioning

confidence: 99%

Prebirth effects of climate change on children's respiratory health

Yadav

Pacheco

2023

Current Opinion in Pediatrics

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Purpose of reviewTo date, there is no evidence that humanity will implement appropriate mitigation measures to avoid the catastrophic impact of climate change on the planet and human health. Vulnerable populations such as pregnant women and children will be the most affected. This review highlights epidemiologic data on climate change-related prenatal environmental exposures affecting the fetus and children's respiratory health.Recent findingsResearch on outcomes of prenatal exposure to climate change-related environmental changes and pediatric pulmonary health is limited. In addition to adverse pregnancy outcomes known to affect lung development, changes in lung function, increased prevalence of wheezing, atopy, and respiratory infections have been associated with prenatal exposure to increased temperatures, air pollution, and maternal stress. The mechanisms behind these changes are ill-defined, although oxidative stress, impaired placental functioning, and epigenetic modifications have been observed. However, the long-term impact of these changes remains unknown.SummaryThe detrimental impact of the climate crisis on pediatric respiratory health begins before birth, highlighting the inherent vulnerability of pregnant women and children. Research and advocacy, along with mitigation and adaptation measures, must be implemented to protect pregnant women and children, the most affected but the least responsible for the climate crisis.

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“… 27 – 30 Prenatal exposures to air pollution have also been directly linked to adverse respiratory outcomes in childhood and adulthood, including, but not limited to, the development of asthma, 12 , 30 , 31 allergic rhinitis, 32 chronic obstructive pulmonary disease, 29 as well as reduced pulmonary function 26 , 33 and increased incidence and severity of respiratory infections. 21 , 34 These findings suggest that in utero exposure to air pollution-mediated growth deficits are part of a continuum that may promote the development of adverse respiratory outcomes later in life.…”

Section: Introductionmentioning

confidence: 98%

Prenatal Exposure to Air Pollution and Respiratory Distress in Term Newborns: Results from the MIREC Prospective Pregnancy Cohort

Johnson,

Mazur,

Fisher

et al. 2024

Environ Health Perspect

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Background: Respiratory distress is the leading cause of neonatal morbidity and mortality worldwide, and prenatal exposure to air pollution is associated with adverse long-term respiratory outcomes; however, the impact of prenatal air pollution exposure on neonatal respiratory distress has not been well studied. Objectives: We examined associations between prenatal exposures to fine particular matter ( ) and nitrogen dioxide ( ) with respiratory distress and related neonatal outcomes. Methods: We used data from the Maternal–Infant Research on Environmental Chemicals (MIREC) Study, a prospective pregnancy cohort ( ) recruited in the first trimester from 10 Canadian cities. Prenatal exposures to ( ) and ( ) were estimated using land-use regression and satellite-derived models coupled with ground-level monitoring and linked to participants based on residential location at birth. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between air pollution and physician-diagnosed respiratory distress in term neonates in hierarchical logistic regression models adjusting for detailed maternal and infant covariates. Results: Approximately of newborns experienced respiratory distress. Neonates received clinical interventions including oxygen therapy (6%), assisted ventilation (2%), and systemic antibiotics (3%). Two percent received multiple interventions and 4% were admitted to the neonatal intensive care unit (NICU). Median and concentrations during pregnancy were and , respectively. Prenatal exposures to air pollution were not associated with physician-diagnosed respiratory distress, oxygen therapy, or NICU admissions. However, exposures were strongly associated with assisted ventilation (OR per increase in ; 95% CI: 1.02, 1.35), multiple clinical interventions (OR per increase in ; 95% CI: 1.07, 1.26), and systemic antibiotics, (OR per increase in ; 95% CI: 1.04, 1.21). These associations were consistent across exposure periods—that is, during prepregnancy, individual trimesters, and total pregnancy—and robust to model specification. exposure was associated with administration of systemic antibiotics (OR per 1-ppb increase in ; 95% CI: 1.00, 1.06). Discussion: Prenatal exposures to increased the risk of severe respiratory distress among term newborns. These findings support the development and prioritization of public health and prenatal care strategies to increase awareness and minimize prenatal exposures to air pollution. https://doi.org/10.1289/EHP12880

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Preconceptional and prenatal exposure to air pollution increases incidence of childhood pneumonia: A hypothesis of the (pre-)fetal origin of childhood pneumonia

Cited by 14 publications

References 59 publications

Prenatal and early life exposure to air pollution and the risk of severe lower respiratory tract infections during early childhood: the Espoo Cohort Study

Prenatal and early life exposure to air pollution and the risk of severe lower respiratory tract infections during early childhood: the Espoo Cohort Study

Prebirth effects of climate change on children's respiratory health

Prenatal Exposure to Air Pollution and Respiratory Distress in Term Newborns: Results from the MIREC Prospective Pregnancy Cohort

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