Abstract
Background: We previously identified associations between trimester-specific NO 2exposures and reduced fetal growth in the Spanish INfancia y Medio Ambiente (INMA) project. Here, we use temporally refined exposure estimates to explore the impact of narrow (weekly) windows of exposure on fetal growth. Methods: We included 1,685 women from INMA with serial ultrasounds at 12, 20, and 34 gestational weeks. We measured biparietal diameter (BPD), femur length, and abdominal circumference (AC) and from them calculated estimated fetal weight (EFW). We calculated z-scores describing trajectories of each parameter during early (0-12 weeks), mid (12-20 weeks), and late (20-34 weeks) pregnancy, based on longitudinal growth curves from mixed-effects models. We estimated weekly NO 2exposures at each woman's residence using land-use regression models. We applied distributed lag nonlinear models to identify sensitive windows of exposure. We present effect estimates as the percentage change in fetal growth per 10 μg/m 3increase in NO 2exposure, and we calculated cumulative effect estimates by aggregating estimates across adjacent lags. Results: We identified weeks 5-12 as a sensitive window for NO 2exposure on late EFW (cumulative β = -3.0%; 95% CI = -4.1%, -1.9%). We identified weeks 6-19 as a sensitive window for late growth in BPD (cumulative β = -2.0%; 95% CI = -2.7%, -1.4%) and weeks 8-13 for AC (cumulative β = -0.68%; 95% CI = -0.97%, -0.40%). We found suggestive evidence that third trimester NO 2exposure is associated with increased AC, BPD, and EFW growth in late pregnancy. Conclusions: Our findings are consistent with the hypothesis that NO 2exposure is associated with alterations in growth of EFW, BPD, and AC dependent on the specific timing of exposure during gestation.
Original language | English |
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Pages (from-to) | 318-324 |
Number of pages | 7 |
Journal | Epidemiology |
Volume | 33 |
Issue number | 3 |
DOIs | |
Publication status | Published - 1 May 2022 |
Bibliographical note
Funding Information:K.W.W. and E.S. were partially supported by the P30 Environmental Health Sciences Core Center grant P30ES030285 from the National Institutes of Health/National Institute of Environmental Health Sciences (NIH/NIEHS). This work was supported by grant R01ES028842 from NIH/NIEHS; grants Red INMA G03/176, CB06/02/004; FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/0867, PI06/1213, PI07/0314, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, PI17/00663, FIS-PI18/01142 incl. FEDER funds; Miguel Servet-FEDER CP11/00178, CP15/00025, CPII16/00051, CPII18/00018, and CP16/00128 from Instituto de Salud Carlos III, grant 1999SGR 00241from Generalitat de Catalunya-CIRIT, grant FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1 from the EU Commission, grant UGP-15-230, UGP-15-244, and UGP-15-249 from Generalitat Valenciana: FISABIO, grant 2005111093 from Alicia Koplowitz Foundation 2017, Department of Health of the Basque Government, grant DFG06/002 from the Provincial Government of Gipuzkoa, and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain). We also acknowledge support from the Spanish Ministry of Science and Innovation and the State Research Agency through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program.
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