Association between exposure to air pollution during intrauterine life and cephalic circumference of the newborn
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RESEARCH ARTICLE
Association between exposure to air pollution during intrauterine life and cephalic circumference of the newborn Mariana Azevedo Carvalho 1 & Karen Hettfleisch 1 & Agatha S Rodrigues 1,2 & Alexandra Benachi 3 & Sandra Elisabete Vieira 4 & Silvia R. D. M. Saldiva 5 & Paulo Hilário N. Saldiva 6 & Rossana Pulcineli Vieira Francisco 1 & Lisandra Stein Bernardes 1 Received: 24 June 2020 / Accepted: 15 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract It has been observed that air pollution can affect newborn health due to the negative effects of pollutants on pregnancy development. However, few studies have evaluated the impact of maternal exposure to urban air pollution on head circumference (HC) at birth. Reduced head growth during pregnancy may be associated with neurocognitive deficits in childhood. The objectives of this study were to evaluate the association between maternal exposure to air pollution and HC at birth and to provide context with a systematic review to investigate this association. This was a prospective study of low-risk pregnant women living in São Paulo, Brazil. Exposure to pollutants, namely, nitrogen dioxide (NO2) and ozone (O3), was measured during each trimester using passive personal samplers. We measured newborn HC until 24 h after birth. We used multiple linear regression models to evaluate the association between pollutants and HC while controlling for known determinants of pregnancy. To perform the systematic review, four different electronic databases were searched through November 2018: CENTRAL, EMBASE, LILACS, and MEDLINE. We selected longitudinal or transversal designs associating air pollution and HC at birth. Two reviewers evaluated the inclusion criteria and risk of bias and extracted data from the included papers. Thirteen studies were selected for the systematic review. We evaluated 391 patients, and we did not observe a significant association between air pollution and HC. Regarding the systematic review, 13 studies were selected for the systematic review, 8 studies showed an inverse association between maternal exposure to pollutants and HC, 4 showed no association, and one observed a direct association. In the city of São Paulo, maternal exposure to pollutants was not significantly associated with HC at birth. The systematic review suggested an inverse association between air pollution and HC at birth. Keywords Head circumference . Nitrogen dioxide . Ozone . Personal monitoring . Maternal exposure . Air pollution
Introduction Over the last two decades, harmful effects of exposure to air pollution during pregnancy have been shown. A lower expected birth weight has been the principal outcome investigated,
and many studies support the negative influence of air pollution on birth weight (Pedersen et al. 2013; van den Hooven et al. 2012). However, the effects of air pollution on head size at birth have been evaluated as a secondary outcome, and the association with air pollution is still unclear. Since reduced
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