Maternal exposure to air pollution and the risk of small for gestational age in offspring: A population-based study in Taiwan

Background: Exposure to air pollution has been associated with a wide range of adverse health effects; however, few studies addressed the relationship between ambient particulate matter as well as the compositions in particulate matter such as lead and the risk of small for gestational age (SGA) in offspring. The aim of this study is to investigate the effect of maternal exposure to criteria air pollutants and the lead in total suspended particulate matter during pregnancy on SGA births in Taiwan. Methods: This population study consisted of 322,513 singleton live births in Taiwan between 1996 and 2002. Daytime (7 AM-7 PM) exposure to particulate matter <= 10 mu m (PM10), carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O-3), and monthly exposure to lead in total suspended particles (TSP) during each trimester were estimated. Generalized additive model (GAM) was used to assess the association between maternal exposure to particulate air pollutants and SGA births, taking into account potential confounders and gaseous air pollutants. Results: We found significant association between the highest quartile (>= 75th) of maternal PM10 exposure and SGA and demonstrated a significant exposure-response relationship. Furthermore, the highest quartile (>= 75th) of maternal lead exposure was also associated with SGA during the second and third trimester of pregnancy, and there was a significant exposure-response relationship between maternal lead exposure and SGA during pregnancy. Conclusion: Maternal exposure to PM10 and lead in total suspended particulate matter during pregnancy was associated with an increased risk of SGA in offspring. Copyright (C) 2019, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC.