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Prenatal and postnatal exposure to NO2 and rapid infant weight gain - A population-based cohort study
Neora Alterman1, Iaroslav Youssim1, Daniel Nevo2
1Braun School of Public Health and Community Medicine, The Hebrew University at Jerusalem - Hadassah, Jerusalem, Israel.
Insights
Exposure to traffic-related air pollution, specifically nitrogen dioxide (NO2), during pregnancy and early infancy is linked to rapid infant weight gain. This early weight gain is a risk factor for childhood overweight and obesity.
Area of Science:
- Environmental Health
- Pediatrics
- Epidemiology
Background:
- Childhood overweight and obesity represent a significant global health challenge.
- Rapid infant weight gain is a key predictor of childhood overweight.
- Ambient air pollution exposure, particularly during pregnancy, has been linked to increased risk of rapid infant weight gain.
Purpose of the Study:
- To investigate the association between prenatal and postnatal exposure to ambient nitrogen dioxide (NO2), a marker for traffic-related air pollution, and rapid infant weight gain.
- To identify critical exposure periods for NO2 and their impact on infant growth velocity.
Main Methods:
- A population-based cohort study of 474,136 infants in central Israel (2011-2019) was conducted.
- Weekly average NO2 concentrations during pregnancy and the first four postnatal weeks were assessed using an optimized dispersion model.
- Weight gain velocity was modeled using the SuperImposition by Translation and Rotation (SITAR) method, with rapid weight gain defined as the highest tertile of velocity.
Main Results:
- Increased NO2 exposure during pregnancy was associated with a 1.02 relative risk (95% CI 1.00, 1.04) for rapid infant weight gain per interquartile range increase.
- Postnatal NO2 exposure in the first four weeks of life also showed a 1.02 relative risk (95% CI 1.01, 1.04) for rapid weight gain.
- The critical period for prenatal NO2 exposure risk extended from mid-pregnancy to birth.
Conclusions:
- Both prenatal and postnatal exposure to elevated levels of traffic-related air pollution (NO2) are independently associated with rapid infant weight gain.
- Rapid infant weight gain is a significant risk factor for the development of childhood overweight and obesity.
- Findings highlight the importance of reducing air pollution exposure for infant health and long-term weight management.
Background:
Childhood overweight and obesity is a global public health problem. Rapid infant weight gain is predictive of childhood overweight. Studies found that exposure to ambient air pollution is associated with childhood overweight, and have linked prenatal exposure to air pollution with rapid infant weight gain.
Objectives:
To examine the association between prenatal and postnatal ambient NO2 exposure, a traffic-related marker, with rapid weight gain in infants.
Methods:
We carried out a population-based historical cohort study using data from the Israeli national network of maternal and child health clinics. The study included 474,136 infants born at term with birthweight ≥2500 g in 2011-2019 in central Israel. Weekly averages of NO2 concentration throughout pregnancy (prenatal) and the first 4 weeks of life (postnatal) were assessed using an optimized dispersion model and were linked to geocoded home addresses. We modelled weight gain velocity throughout infancy using the SuperImposition by Translation and Rotation (SITAR) method, a mixed-effects nonlinear model specialized for modelling growth curves, and defined rapid weight gain as the highest velocity tertile. Distributed-lag models were used to assess critical periods of risk and to measure relative risks for rapid weight gain. Adjustments were made for socioeconomic status, population group, subdistrict, month and year of birth, and the alternate exposure period - prenatal or postnatal.
Results:
The cumulative adjusted relative risk for rapid weight gain of NO2 exposure was 1.02 (95% confidence intereval [CI] 1.00, 1.04) for exposure throughout pregnancy and 1.02 (95% CI 1.01, 1.04) for exposure during the first four postnatal weeks per NO2 interquartile range increase (7.3 ppb). An examination of weekly associations revealed that the critical period of risk for the prenatal exposure was from mid-pregnancy to birth.
Conclusions:
Prenatal and postnatal exposures to higher concentrations of traffic-related air pollution are each independently associated with rapid infant weight gain, a risk factor for childhood overweight and obesity.
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