Maternal Ambient Exposure to Atmospheric Pollutants during Pregnancy and Offspring Term Birth Weight in the Nationwide ELFE Cohort
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Maternal Exposure
2.3. Contextual Characteristics
2.4. Regression Models
3. Results
3.1. Main Analysis
3.2. Sensitivity Analyses
3.3. Doubly Robust GAM
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Whole ELFE Population (n = 17,358) | Included Population (n = 13,334) | Excluded Population (n = 4024) | p-Value 1 | ||||
---|---|---|---|---|---|---|---|
n | n (%) or Mean ± sd | n | n (%) or Mean ± sd | n | n (%) or Mean ± sd | ||
Maternal age (years) | 17,186 | 30.6 ± 5.0 | 13,334 | 30.7 ± 5.0 | 3852 | 30.5 ± 5.1 | 0.03 |
In relationship (married, cohabitation) | 17,100 | 13,334 | 3766 | ||||
Yes | 16,177 (94.6) | 12,608 (94.6) | 3569 (94.8) | 0.61 | |||
No | 923 (5.4) | 726 (5.4) | 197 (5.2) | ||||
Maternal level of education | 17,191 | 13,334 | 3857 | ||||
Up to Secondary School | 844 (4.9) | 630 (4.7) | 214 (5.5) | 0.05 | |||
Vocational qualification | 2384 (13.9) | 1823 (13.7) | 561 (14.5) | ||||
High School | 3586 (20.9) | 2814 (21.1) | 772 (20.0) | ||||
University degree | 10,377 (60.4) | 8067 (60.5) | 2310 (59.9) | ||||
Maternal French citizenship | 17,085 | 13,334 | 3751 | ||||
Yes | 15,051 (88.1) | 11,761 (88.2) | 3290 (87.7) | 0.41 | |||
No | 2034 (11.9) | 1573 (11.8) | 461 (12.3) | ||||
Parity | 16,675 | 13,334 | 3341 | ||||
0 | 7887 (47.3) | 6015 (45.1) | 1872 (56.0) | <0.001 | |||
1 child | 5596 (33.6) | 4647 (34.9) | 949 (28.4) | ||||
2 children | 2222 (13.3) | 1876 (14.1) | 346 (10.4) | ||||
≥3 children | 970 (5.8) | 796 (6.0) | 174 (5.2) | ||||
Maternal height (cm) | 17,191 | 165.0 ± 6.3 | 13,334 | 165.0 ± 6.3 | 3857 | 165.2 ± 6.3 | 0.07 |
Maternal weight before pregnancy (kg) | 16,965 | 63.9 ± 13.6 | 13,334 | 64.0 ± 13.6 | 3631 | 63.9 ± 13.9 | 0.93 |
Maternal active smoking during pregnancy | 17,054 | 13,334 | 4679 | ||||
Yes | 3393 (19.9) | 2615 (19.6) | 1013 (21.6) | 0.08 | |||
No | 13,661 (80.1) | 10,719 (80.4) | 3666 (78.4) | ||||
Deprivation index (EDI, quintile) | 16,466 | 13,334 | 3132 | ||||
Q1 (least deprived) | 2808 (17.1) | 2287 (17.2) | 521 (16.6) | 0.35 | |||
Q2 | 2902 (17.6) | 2383 (17.9) | 519 (16.6) | ||||
Q3 | 2688 (16.3) | 2166 (16.2) | 522 (16.7) | ||||
Q4 | 3090 (18.8) | 2499 (18.7) | 591 (18.9) | ||||
Q5 (most deprived) | 4978 (30.2) | 3999 (30.0) | 979 (31.3) | ||||
Urbanization level | 16,469 | 13,334 | 3135 | ||||
City-center areas | 2797 (17.0) | 2266 (17.0) | 531 (16.9) | 0.003 | |||
Suburban areas | 9148 (55.5) | 7331 (55.0) | 1817 (58.0) | ||||
Rural areas | 4524 (27.5) | 3737 (28.0) | 787 (25.1) | ||||
Season of conception | 17,060 | 13,334 | 3726 | ||||
January–March | 9096 (53.3) | 6694 (50.2) | 2402 (64.5) | <0.001 | |||
April–June | 323 (1.9) | 263 (2.0) | 60 (1.6) | ||||
July–September | 3136 (18.4) | 2674 (20.1) | 462 (12.4) | ||||
October–December | 4505 (26.4) | 3703 (27.8) | 802 (21.5) | ||||
Gestational duration (weeks) | 17,060 | 40.0 ± 1.2 | 13,334 | 40.0 ± 1.2 | 3726 | 39.8 ± 1.3 | <0.001 |
Sex of infant | 17,102 | 13,334 | 3768 | ||||
Boy | 8770 (51.3) | 6915 (51.9) | 1855 (49.2) | 0.004 | |||
Girl | 8332 (48.7) | 6419 (48.1) | 1913 (50.8) | ||||
Term Birth weight (g; at ≥ 37 weeks) | 16,849 | 3353 ± 459 | 13,334 | 3364 ± 450 | 3515 | 3313 ± 490 | <0.001 |
Pollutant and Exposure Window | Percentiles | ||||||||
---|---|---|---|---|---|---|---|---|---|
n | Mean | sd | p5 | p25 | p50 | p75 | p95 | IQR | |
PM2.5 | |||||||||
Whole pregnancy | 13,334 | 17.25 | 2.87 | 12.92 | 15.29 | 16.93 | 19.03 | 22.54 | 3.74 |
Whole pregnancy, truncated 1 | 13,334 | 17.25 | 3.16 | 12.51 | 15.02 | 16.92 | 19.21 | 22.96 | 4.18 |
1st trimester | 13,334 | 18.87 | 5.56 | 10.89 | 14.69 | 18.06 | 22.41 | 29.16 | 7.71 |
2nd trimester | 13,334 | 16.65 | 6.49 | 8.93 | 11.56 | 14.69 | 20.88 | 29.24 | 9.32 |
3rd trimester | 13,334 | 16.15 | 5.74 | 9.65 | 12.10 | 14.49 | 19.24 | 28.04 | 7.14 |
3rd trimester, truncated 1 | 13,334 | 15.74 | 5.86 | 9.04 | 11.67 | 14.30 | 17.70 | 28.19 | 6.03 |
30 days before delivery | 13,334 | 17.12 | 7.64 | 8.77 | 10.75 | 14.66 | 22.36 | 31.70 | 11.61 |
60 days before delivery | 13,334 | 16.01 | 6.54 | 9.14 | 10.72 | 14.05 | 19.95 | 29.13 | 9.22 |
90 days before delivery | 13,334 | 15.86 | 5.33 | 9.58 | 12.16 | 14.44 | 18.70 | 26.86 | 6.54 |
PM10 | |||||||||
Whole pregnancy | 13,334 | 24.45 | 3.40 | 19.33 | 21.93 | 24.11 | 26.79 | 30.44 | 4.86 |
Whole pregnancy, truncated 1 | 13,334 | 24.42 | 3.63 | 18.95 | 21.79 | 24.13 | 26.86 | 30.86 | 5.07 |
1st trimester | 13,334 | 25.95 | 6.21 | 17.35 | 21.12 | 24.97 | 30.14 | 37.10 | 9.02 |
2nd trimester | 13,334 | 23.70 | 6.85 | 14.98 | 18.40 | 22.15 | 27.97 | 36.97 | 9.57 |
3rd trimester | 13,334 | 23.65 | 6.20 | 15.54 | 19.17 | 22.11 | 27.42 | 36.12 | 8.25 |
3rd trimester, truncated 1 | 13,334 | 23.22 | 6.56 | 14.76 | 18.50 | 21.76 | 26.91 | 36.04 | 8.40 |
30 days before delivery | 13,334 | 24.50 | 8.10 | 14.91 | 17.58 | 22.61 | 30.31 | 39.82 | 12.73 |
60 days before delivery | 13,334 | 23.38 | 6.84 | 15.43 | 18.06 | 21.49 | 27.70 | 37.27 | 9.64 |
90 days before delivery | 13,334 | 23.35 | 5.80 | 15.53 | 19.20 | 21.94 | 26.98 | 34.88 | 7.78 |
NO2 | |||||||||
Whole pregnancy | 13,334 | 20.01 | 8.89 | 7.71 | 12.82 | 18.85 | 26.22 | 36.15 | 13.40 |
Whole pregnancy, truncated 1 | 13,334 | 19.98 | 9.01 | 7.57 | 12.75 | 18.70 | 26.25 | 36.44 | 13.50 |
1st trimester | 13,334 | 22.08 | 10.34 | 7.44 | 14.05 | 20.70 | 28.88 | 41.17 | 14.83 |
2nd trimester | 13,334 | 19.06 | 10.57 | 5.57 | 10.76 | 16.97 | 25.39 | 39.98 | 14.63 |
3rd trimester | 13,334 | 18.80 | 10.06 | 5.81 | 10.98 | 16.95 | 25.00 | 38.86 | 14.02 |
3rd trimester, truncated 1 | 13,334 | 18.24 | 10.03 | 5.51 | 10.32 | 16.29 | 24.34 | 38.23 | 14.02 |
30 days before delivery | 13,334 | 19.80 | 10.93 | 5.45 | 11.04 | 17.95 | 26.99 | 40.68 | 15.95 |
60 days before delivery | 13,334 | 18.74 | 10.17 | 5.54 | 10.76 | 16.92 | 25.07 | 38.42 | 14.31 |
90 days before delivery | 13,334 | 18.61 | 9.82 | 5.83 | 10.91 | 16.82 | 24.91 | 38.05 | 14.00 |
Large City-Center Area (n = 2266) | Suburban Areas (n = 7331) | Rural Areas (n = 3737) | p-Value 2 | ||||
---|---|---|---|---|---|---|---|
β | (95% CI) | β | (95% CI) | β | (95% CI) | ||
PM2.5 | |||||||
Whole pregnancy | 40.8 | (8.32, 73.36) | 7.4 | (−15.45, 30.26) | 3.9 | (−30.66, 38.45) | 0.120 |
Whole pregnancy, truncated 3 | 31.9 | (2.78, 61.07) | 5.7 | (−14.74, 26.19) | 12.1 | (−18.63, 42.78) | 0.241 |
1st trimester | 38.1 | (22.74, 53.46) | 38.1 | (27.56, 48.53) | 68.0 | (52.42, 83.67) | 0.001 |
2nd trimester | −7.5 | (−22.02, 6.97) | −9.6 | (−20.05, 0.91) | −19.3 | (−34.20, −4.44) | 0.326 |
3rd trimester | −9.8 | (−25.37, 5.71) | −25.1 | (−35.39, −14.75) | −46.8 | (−62.31, −31.29) | 0.001 |
3rd trimester, truncated 3 | −30.0 | (−45.61, −14.45) | −45.6 | (−56.37, −34.76) | −69.3 | (−84.86, −53.8) | 0.000 |
30 days before delivery | 8.9 | (−2.41, 20.22) | −1.9 | (−9.10, 5.26) | −9.0 | (−20.32, 2.37) | 0.062 |
60 days before delivery | 2.4 | (−11.08, 15.87) | −8.4 | (−17.26, 0.41) | −21.4 | (−34.87, −7.87) | 0.026 |
90 days before delivery | −3.1 | (−19.94, 13.71) | −15.5 | (−26.62, −4.35) | −36.3 | (−52.94, −19.65) | 0.007 |
PM10 | |||||||
Whole pregnancy | 32.6 | (8.70, 56.54) | 7.6 | (−11.60, 26.87) | −9.1 | (−40.14, 22.04) | 0.058 |
Whole pregnancy, truncated 3 | 29.7 | (7.08, 52.21) | 6.9 | (−10.49, 24.33) | 0.7 | (−26.81, 28.30) | 0.141 |
1st trimester | 37.8 | (24.11, 51.57) | 35.2 | (25.43, 45.03) | 59.0 | (44.59, 73.46) | 0.007 |
2nd trimester | 0.0 | (−13.17, 13.13) | −6.2 | (−15.78, 3.36) | −15.4 | (−28.80, −2.09) | 0.172 |
3rd trimester | −5.1 | (−18.92, 8.70) | −21.4 | (−31.15, −11.68) | −47.9 | (−62.09, −33.67) | 0.000 |
3rd trimester, truncated 3 | −23.1 | (−36.73, −9.49) | −37.9 | (−47.88, −27.84) | −64.1 | (−77.95, −50.24) | 0.000 |
30 days before delivery | 9.9 | (−0.58, 20.33) | −0.9 | (−7.83, 6.05) | −8.8 | (−19.44, 1.81) | 0.031 |
60 days before delivery | 3.7 | (−8.98, 16.37) | −7.5 | (−16.12, 1.17) | −24.0 | (−36.57, −11.44) | 0.003 |
90 days before delivery | 0.8 | (−13.87, 15.45) | −11.7 | (−22.14, −1.32) | −38.0 | (−53.31, −22.66) | 0.000 |
NO2 | |||||||
Whole pregnancy | 32.7 | (7.99, 57.34) | −7.7 | (−22.23, 6.91) | −0.3 | (−33.39, 32.76) | 0.010 |
Whole pregnancy, truncated 3 | 31.0 | (7.20, 54.81) | −7.6 | (−21.91, 6.77) | 1.8 | (−29.84, 33.52) | 0.011 |
1st trimester | 37.8 | (18.74, 56.83) | 12.9 | (0.83, 24.96) | 46.3 | (20.67, 71.98) | 0.007 |
2nd trimester | 0.5 | (−17.84, 18.79) | −15.0 | (−27.71, −2.35) | −23.6 | (−49.27, 2.04) | 0.164 |
3rd trimester | 9.5 | (−9.09, 28.03) | −12.8 | (−24.81, −0.86) | −37.6 | (−65.10, −10.08) | 0.010 |
3rd trimester, truncated 3 | −2.2 | (−20.43, 15.98) | −20.3 | (−32.37, −8.26) | −56.6 | (−83.53, −29.70) | 0.002 |
30 days before delivery | 22.5 | (5.57, 39.47) | −0.8 | (−11.73, 10.11) | 0.1 | (−23.40, 23.64) | 0.043 |
60 days before delivery | 14.0 | (−4.49, 32.56) | −6.0 | (−17.71, 5.71) | −18.3 | (−44.47, 7.94) | 0.066 |
90 days before delivery | 12.3 | (−6.88, 31.44) | −7.8 | (−20.02, 4.42) | −28.3 | (−56.58, −0.01) | 0.037 |
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Ouidir, M.; Seyve, E.; Rivière, E.; Bernard, J.; Cheminat, M.; Cortinovis, J.; Ducroz, F.; Dugay, F.; Hulin, A.; Kloog, I.; et al. Maternal Ambient Exposure to Atmospheric Pollutants during Pregnancy and Offspring Term Birth Weight in the Nationwide ELFE Cohort. Int. J. Environ. Res. Public Health 2021, 18, 5806. https://doi.org/10.3390/ijerph18115806
Ouidir M, Seyve E, Rivière E, Bernard J, Cheminat M, Cortinovis J, Ducroz F, Dugay F, Hulin A, Kloog I, et al. Maternal Ambient Exposure to Atmospheric Pollutants during Pregnancy and Offspring Term Birth Weight in the Nationwide ELFE Cohort. International Journal of Environmental Research and Public Health. 2021; 18(11):5806. https://doi.org/10.3390/ijerph18115806
Chicago/Turabian StyleOuidir, Marion, Emie Seyve, Emmanuel Rivière, Julien Bernard, Marie Cheminat, Jérôme Cortinovis, François Ducroz, Fabrice Dugay, Agnès Hulin, Itai Kloog, and et al. 2021. "Maternal Ambient Exposure to Atmospheric Pollutants during Pregnancy and Offspring Term Birth Weight in the Nationwide ELFE Cohort" International Journal of Environmental Research and Public Health 18, no. 11: 5806. https://doi.org/10.3390/ijerph18115806