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Publications

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. Ppublish 112 citations

PubMed: 35040691 DOI: 10.1289/EHP9509

Prenatal Exposure to Air Pollution and Autism Spectrum Disorder: Sensitive Windows of Exposure and Sex Differences.

Environ Health Perspect 130(1):17008

Authors: Md Mostafijur Rahman, Yu-Hsiang Shu, Ting Chow, Frederick W Lurmann, Xin Yu, Mayra P Martinez, Sarah A Carter, Sandrah P Eckel, Jiu-Chiuan Chen, Zhanghua Chen, Pat Levitt, Joel Schwartz, Rob McConnell, Anny H Xiang

Affiliations

  • Department of Preventive Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA.
  • Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.
  • Sonoma Technology, Inc. Petaluma, California, USA.
  • Spatial Science Institute, USC, Los Angeles, California, USA.
  • Department of Pediatrics and Program in Developmental Neuroscience and Neurogenetics, Keck School of Medicine, Saban Research Institute, Children's Hospital Los Angeles, USC, Los Angeles, California, USA.
  • Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
  • Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Abstract

BACKGROUND

Studies have shown that air pollution exposures during pregnancy are associated with an increased risk of autism spectrum disorder (ASD) in children, and the risk appears to be greater for boys. However, studies assessing gestational windows of susceptibility have been mostly limited by trimesters.

OBJECTIVE

We identified sensitive windows of exposure to regional air pollution and risk of ASD and examined sex differences in a large birth cohort.

METHODS

This population-based retrospective cohort study included 294,937 mother-child pairs with singleton deliveries in Kaiser Permanente Southern California (KPSC) hospitals from 2001 to 2014. Children were followed using electronic medical records until clinical ASD diagnosis, non-KPSC membership, death, or 31 December 2019, whichever came first. Weekly mean fine particulate matter [PM with an aerodynamic diameter of ()], nitrogen dioxide (), and ozone () pregnancy exposures were estimated using spatiotemporal prediction models. Cox proportional hazard models with distributed lags were used to estimate weekly pollutant exposure associations with ASD risk for the entire cohort, and separately for boys and for girls. Models were adjusted for child sex (for full cohort), maternal race/ethnicity, maternal age at delivery, parity, maternal education, maternal comorbidities, medical center, census tract median household income, birth year, and season.

RESULTS

There were 5,694 ASD diagnoses (4,636 boys, 1,058 girls). Sensitive exposure windows associated with ASD were found early in pregnancy, statistically significant throughout the first two trimesters [1-27 wk of gestation, cumulative [95% confidence interval (CI): 1.06, 1.23] per interquartile range (IQR) () increase]. exposure during 34-37 wk of gestation was associated with increased risk [ (95% CI: 1.01, 1.11) per IQR () increase] but with reduced risk during 20-28 wk of gestation [ (95% CI: 0.89, 0.98)]. No associations were observed with . Sex-stratified early gestational associations were stronger among boys [boys (95% CI: 1.08, 1.26); girls (95% CI: 0.89, 1.26)]. associations in later gestation were observed only in boys [boys (95% CI: 1.04, 1.16); girls (95% CI: 0.84, 1.05)].

CONCLUSIONS

Exposures to in the first two gestational trimesters were associated with increased ASD risk in children, with stronger associations observed for boys. The role of exposure on ASD risk merits further investigation. https://doi.org/10.1289/EHP9509.

MeSH

Pregnancy, Autism Spectrum Disorder, Parturition, Air Pollution, Autistic Disorder, Air, Environmental Pollution, Sex Characteristics, Sex, Diagnosis, Environmental Health, Environment, Child, Sex Differences

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