Air Pollution Exposure and Markers of Placental Growth and Function: The Generation R Study.

AIR pollution; ANALYSIS of covariance; CONFIDENCE intervals; EPIDEMIOLOGY; LONGITUDINAL method; PLACENTA; REGRESSION analysis; RESEARCH funding; DATA analysis; STATISTICAL models; DESCRIPTIVE statistics; FETUS; PREGNANCY

BACKGROUND: Air pollution exposure during pregnancy might affect placental growth and function, perhaps leading to pregnancy complications. OBJECTIVE: We prospectively evaluated the associations of maternal air pollution exposure with markers of placental growth and function among 7,801 pregnant women in the Netherlands. METHODS: We estimated levels of particulate matter < 10 urn in aerodynamic diameter (PM[sub 10]) and nitrogen dioxide (NO[sub 2]) at the home address for different periods during pregnancy using dispersion modeling techniques. Pro- and anti-angiogenic factors [placental growth factor (P1GF) and soluble fms-like tyrosine kinase 1 (sFlt-1), respectively] were measured in first- and second-trimester maternal blood and in fetal cord blood samples at delivery. Pulsatility index of the uterine and umbilical arteries was measured by Doppler ultrasound in second and third trimester, and notching was assessed in third trimester. Placenta weight and birth weight were obtained from medical records. RESULTS: Higher PM[sub 10] andNO[sub 2] exposure levels were associated with lower second-trimester maternal sFlt-1 and P1GF levels. PM[sub 10] and NO[sub 2] exposures averaged over total pregnancy were associated with higher sFlt-1 and lower P1GF levels in fetal cord blood, consistent with an anti-angiogenic state. PM[sub 10] and NO[sub 2] exposures were not consistently associated with second- or third-trimester placental resistance indices. NO[sub 2] exposure was associated with third-trimester notching (odds ratio 1.33; 95% CI: 0.99, 1.78 per 10-Μg/m[sup 3] increase in the prior 2 months). PM[sub 10] and NO[sub 2] exposures were associated with lower placenta weight ( - 11.8 g; 95% CI: -- 20.9, -- 2.7, and -- 10.7 g; 95% CI: -- 19.0, -- 2.4, respectively, per 10-Μg/m[sup 3] increase in the prior 2 months), but not with placenta to birth weight ratio. CONCLUSIONS: Our results suggest that maternal air pollution exposure may influence markers of placental growth and function. Future studies are needed to confirm these findings and explore the maternal and fetal consequences. [ABSTRACT FROM AUTHOR]

Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)