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Chen WJ, Rector-Houze AM, Guxens M, Iñiguez C, Swartz MD, Symanski E, Ibarluzea J, Valentin A, Lertxundi A, González-Safont L, Sunyer J, Whitworth KW. Susceptible windows of prenatal and postnatal fine particulate matter exposures and attention-deficit hyperactivity disorder symptoms in early childhood. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:168806. [PMID: 38016567 DOI: 10.1016/j.scitotenv.2023.168806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023]
Abstract
Few prior studies have explored windows of susceptibility to fine particulate matter (PM2.5) in both the prenatal and postnatal periods and children's attention-deficit/hyperactivity disorder (ADHD) symptoms. We analyzed data from 1416 mother-child pairs from the Spanish INMA (INfancia y Medio Ambiente) Study (2003-2008). Around 5 years of age, teachers reported the number of ADHD symptoms (i.e., inattention, hyperactivity/impulsivity) using the ADHD Diagnostic and Statistical Manual of Mental Disorders. Around 7 years of age, parents completed the Conners' Parent Rating Scales, from which we evaluated the ADHD index, cognitive problems/inattention, hyperactivity, and oppositional subscales, reported as age- and sex-standardized T-scores. Daily residential PM2.5 exposures were estimated using a two-stage random forest model with temporal back-extrapolation and averaged over 1-week periods in the prenatal period and 4-week periods in the postnatal period. We applied distributed lag non-linear models within the Bayesian hierarchical model framework to identify susceptible windows of prenatal or postnatal exposure to PM2.5 (per 5-μg/m3) for ADHD symptoms. Models were adjusted for relevant covariates, and cumulative effects were reported by aggregating risk ratios (RRcum) or effect estimates (βcum) across adjacent susceptible windows. A similar susceptible period of exposure to PM2.5 (1.2-2.9 and 0.9-2.7 years of age, respectively) was identified for hyperactivity/impulsivity symptoms assessed ~5 years (RRcum = 2.72, 95% credible interval [CrI] = 1.98, 3.74) and increased hyperactivity subscale ~7 years (βcum = 3.70, 95% CrI = 2.36, 5.03). We observed a susceptibility period to PM2.5 on risk of hyperactivity/impulsivity symptoms ~5 years in gestational weeks 16-22 (RRcum = 1.36, 95% CrI = 1.22, 1.52). No associations between PM2.5 exposure and other ADHD symptoms were observed. We report consistent evidence of toddlerhood as a susceptible window of PM2.5 exposure for hyperactivity in young children. Although mid-pregnancy was identified as a susceptible period of exposure on hyperactivity symptoms in preschool-aged children, this association was not observed at the time children were school-aged.
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Affiliation(s)
- Wei-Jen Chen
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alison M Rector-Houze
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Mònica Guxens
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre (Erasmus MC), Rotterdam, the Netherlands
| | - Carmen Iñiguez
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Statistics and Operational Research, Universitat de València, València, Spain; Epidemiology and Environmental Health Joint Research Unit, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Universitat Jaume I-Universitat de València, València, Spain
| | - Michael D Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Elaine Symanski
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
| | - Jesús Ibarluzea
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastian, Spain; Faculty of Psychology, Universidad del País Vasco (UPV/EHU), San Sebastian, Spain
| | - Antonia Valentin
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Barcelona, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain; Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Llúcia González-Safont
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Universitat Jaume I-Universitat de València, València, Spain; Nursing and Chiropody Faculty of Valencia University, Valencia, Spain
| | - Jordi Sunyer
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; ISGlobal, Barcelona, Spain
| | - Kristina W Whitworth
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
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Park S, Kwon E, Lee G, You YA, Kim SM, Hur YM, Jung S, Jee Y, Park MH, Na SH, Kim YH, Cho GJ, Bae JG, Lee SJ, Lee SH, Kim YJ. Effect of Particulate Matter 2.5 on Fetal Growth in Male and Preterm Infants through Oxidative Stress. Antioxidants (Basel) 2023; 12:1916. [PMID: 38001768 PMCID: PMC10669397 DOI: 10.3390/antiox12111916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Particulate matter 2.5 (PM2.5) levels are associated with adverse pregnancy outcomes. In this retrospective cohort study, we examined whether the concentration of indoor PM2.5 affected pregnancy outcomes. Additionally, we evaluated biomarkers of pregnancy-related complications caused by fine dust. We collected clinical information and data based on residential addresses from the Air Korea database to assess PM2.5 exposure levels. As a multicenter prospective cohort study, we measured the indoor PM2.5 concentration and inflammatory and oxidative stress markers. The PM2.5 concentration of the low-birth-weight (LBW) delivery group was 27.21 μg/m3, which was significantly higher than that of the normal-birth-weight (NBW) group (26.23 μg/m3) (p = 0.02). When the newborns were divided by sex, the PM2.5 concentration of the LBW group was 27.89 μg/m3 in male infants, which was significantly higher than that of the NBW group (26.26 μg/m3) (p = 0.01). In the prospective study, 8-hydroxy-2-deoxyguanosine significantly increased in the high-concentration group (113.55 ng/mL, compared with 92.20 ng/mL in the low-concentration group); in the high-concentration group, the rates of preterm birth (PTB) and small size for gestational age significantly increased (p < 0.01, p = 0.01). This study showed an association between PM2.5, oxidative stress, and fetal growth, with the PTB group being more vulnerable.
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Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Eunjin Kwon
- Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Cheongju-si 28159, Republic of Korea;
| | - Gain Lee
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Soo Min Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Sooyoung Jung
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Yongho Jee
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea;
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea;
| | - Sung Hun Na
- Department of Obstetrics and Gynecology, School of Medicine, Kangwon National University, Chuncheon-si 24289, Republic of Korea;
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea;
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul 02841, Republic of Korea;
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Dongsan Medical Center, Daegu 42601, Republic of Korea;
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, College of Medicine, Ulsan University, Ulsan 44610, Republic of Korea;
| | - Sun Hwa Lee
- Seegene Medical Foundation, Seoul 04805, Republic of Korea;
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
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