Association between air pollution exposure during pregnancy and fetal growth in Air Pollution on Pregnancy Outcome study

초록

Objectives We aimed to investigated whether prenatal exposure to particulate matter (PM)2.5 and PM10 and their constituents had any influence on fetal growth measured by ultrasound in Air Pollution on Pregnancy Outcome (APPO) study. Methods The APPO study is a prospective multicentre cohort study involving more than 1,200 pregnant women who received prenatal care at six university hospitals to evaluate the effect of PM on mother. When the pregnant women visited the hospital for regular evaluation in the 1st, 2nd, and 3rd trimester of pregnancy, we collected information related to pregnancy complications through questionnaires and ultrasound sonography between the period of January 2021 and December 2023. The exposed to PM2.5 and PM10 were measured by portable air quality monitor and was divided into high and low based on the cut-off concentration of 15 for each gestational age. Additionally, growth-related parameters including Crown–rump length (CRL); estimated fetal weight (EFW); biparietal diameter (BPD); abdominal circumference (AC) and femur length (FL) were monitored throughout pregnancy (11-14, 15-22, 23-28 and 32-39 weeks of gestation). We calculated sex and gestational age-specific fetal growth z-score and then defined the corresponding fetal undergrowth. Results Prenatal exposure to PM2.5 and PM10 was not associated with any of the fetal growth parameters (CRL, BPD, AC, FL, and EFW) nor fetal undergrowth in the 1st, 2nd, and 3rd trimester of pregnancy. In addition, there was no association between PM2.5 and PM10 exposure during pregnancy and fetal weight and height after birth. The results remained the same after subgroup analysis by gender of the fetus. Conclusions The study demonstrated that prenatal exposure to PM2.5 and PM10 had no associated with fetal growth measured by ultrasound. APPO study is still ongoing, and a follow-up analysis after a larger participant enrolment may be useful to further investigate any potential influence of air pollution on fetal growth.