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Association between exposure to air pollution during intrauterine life and cephalic circumference of the newborn

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Abstract

It has been observed that air pollution can affect newborn health due to the negative effects of pollutants on pregnancy development. However, few studies have evaluated the impact of maternal exposure to urban air pollution on head circumference (HC) at birth. Reduced head growth during pregnancy may be associated with neurocognitive deficits in childhood. The objectives of this study were to evaluate the association between maternal exposure to air pollution and HC at birth and to provide context with a systematic review to investigate this association. This was a prospective study of low-risk pregnant women living in São Paulo, Brazil. Exposure to pollutants, namely, nitrogen dioxide (NO2) and ozone (O3), was measured during each trimester using passive personal samplers. We measured newborn HC until 24 h after birth. We used multiple linear regression models to evaluate the association between pollutants and HC while controlling for known determinants of pregnancy. To perform the systematic review, four different electronic databases were searched through November 2018: CENTRAL, EMBASE, LILACS, and MEDLINE. We selected longitudinal or transversal designs associating air pollution and HC at birth. Two reviewers evaluated the inclusion criteria and risk of bias and extracted data from the included papers. Thirteen studies were selected for the systematic review. We evaluated 391 patients, and we did not observe a significant association between air pollution and HC. Regarding the systematic review, 13 studies were selected for the systematic review, 8 studies showed an inverse association between maternal exposure to pollutants and HC, 4 showed no association, and one observed a direct association. In the city of São Paulo, maternal exposure to pollutants was not significantly associated with HC at birth. The systematic review suggested an inverse association between air pollution and HC at birth.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This research was supported by the São Paulo Research Foundation (FAPESP), grant number 2008/57717-6 and grant number 2016/14433-4, FAPESP. This study was also financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, São Paulo University Medical School, 255, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 05403-900, Brazil

    Mariana Azevedo Carvalho, Karen Hettfleisch, Agatha S Rodrigues, Rossana Pulcineli Vieira Francisco & Lisandra Stein Bernardes

  2. Department of Statistics, Federal University of Espírito Santo, Vitória, Brazil

    Agatha S Rodrigues

  3. Department of Ob-GYN and Reproductive Medecine, Antoine Beclere Hospital, Assistance Publique-Hopitaux de Paris, 92141, Clamart, France

    Alexandra Benachi

  4. Department of Pediatrics, São Paulo University Medical School, 255, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 05403-900, Brazil

    Sandra Elisabete Vieira

  5. Health Institute, State Health Secretariat, 590, Rua Santo Antônio, São Paulo, 01314-000, Brazil

    Silvia R. D. M. Saldiva

  6. Institute of Advanced Studies of the University of São Paulo, 455, Av. Dr Arnaldo, São Paulo, 01246-903, Brazil

    Paulo Hilário N. Saldiva

Authors
  1. Mariana Azevedo Carvalho
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  2. Karen Hettfleisch
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  3. Agatha S Rodrigues
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  4. Alexandra Benachi
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  5. Sandra Elisabete Vieira
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  6. Silvia R. D. M. Saldiva
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  7. Paulo Hilário N. Saldiva
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  8. Rossana Pulcineli Vieira Francisco
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  9. Lisandra Stein Bernardes
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Mariana Azevedo Carvalho, Karen Hettfleisch, and Lisandra Stein Bernardes. The first draft of the manuscript was written by Mariana Azevedo Carvalho. Agatha S. Rodrigues and Mariana Azevedo Carvalho performed the statistical analysis. Alexandra Benachi, Sandra Elisabete Vieira, Silvia R D M Saldiva, Paulo Hilário N. Saldiva, and Rossana P. V. Francisco commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lisandra Stein Bernardes.

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Ethics approval and consent to participate

This study was approved by the Research Ethics Committee of São Paulo University School of Medicine (number 132/10), and the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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The authors declare that they have no competing interests.

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Carvalho, M., Hettfleisch, K., Rodrigues, A.S. et al. Association between exposure to air pollution during intrauterine life and cephalic circumference of the newborn. Environ Sci Pollut Res 28, 9701–9711 (2021). https://doi.org/10.1007/s11356-020-11274-1

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