While increasing evidence suggests that maternal exposure to high levels of ambient air pollutants during pregnancy plays a critical role in producing adverse pregnancy outcomes, most of the early studies focused on birth outcomes (such as birth weight and preterm birth), very few studies, however, have investigated air pollution in relation to fetal growth measured through ultrasound, a sensitive index and novel approach to examine how early air pollution effects alter fetal growth as the measurement at birth is considered a delayed measure of fetal growth. Furthermore, early studies have been largely conducted in western populations, with few studies conducted in China which has the world's most polluted cities and the largest world burden in adverse pregnancy outcomes. The severe ambient air pollution in China is unfortunate but provides a unique environment to study ambient air pollution and fetal growth. Building upon an on-going large prospective birth cohort study (n=6,000) in 2 Chinese cities which have different types and levels of air pollution, we propose a study to examine the hypothesis that heavy maternal exposure to ambient air pollutants (SO2, NO2, PM10, CO, and O3) during pregnancy results in reductions in fetal growth, and the risk of adverse fetal growth varies by windows of exposure during pregnancy. We will take a novel approach of collecting multiple ultrasound measurements of fetal growth during pregnancy through the on-going prospective birth cohort study. The outcomes of interest of the proposed study are 18,000 ultrasound measures (three measurements for each subject) of biparietal diameter (BPD), occipital frontal diameter (OFD), head circumference (HC), femur length (FL), and abdominal circumference (AC) at 13th, 26th, and 35th week gestation. The daily levels of ambient air pollutants (SO2, NO2, PM10, CO, and O3) will be collected from each cities'EPA stations and major potential confounders will be collected through in-person interviews. Linear mixed effects models will be used to estimate associations between ambient pollutant levels and fetal growth over pregnancy. This study will be the largest among very few prospective studies to look at the impact of air pollution on fetal growth controlling for major confounding factors. In addition it is the only air pollution study in which multiple ultrasounds will be conducted as an objective measure of growth during various stages of gestation. Because China has the world's most polluted cities and the largest burden of adverse pregnancy outcomes, these findings will have important implications for regions of the world with similar and lower levels of pollution, where it would be difficult to investigate the association meaningfully.

Public Health Relevance

Disturbance of fetal development does not only put children at risk for mortality and morbidity in early life but also impair health in adulthood. Because high energy consumption and increased automobile emissions degrade urban air quality in both developed and developing countries, understanding how ambient air pollution impacts fetal development is of public health significance.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Scientist Development Award - Research (K02)
Project #
5K02HD070324-04
Application #
8640200
Study Section
Special Emphasis Panel (ZRG1-BDCN-J (50))
Program Officer
Raju, Tonse N
Project Start
2011-04-07
Project End
2016-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
4
Fiscal Year
2014
Total Cost
$98,518
Indirect Cost
$7,298
Name
Yale University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Tang, Zhongfeng; Zhang, Hanru; Bai, Haiya et al. (2018) Residential mobility during pregnancy in Urban Gansu, China. Health Place 53:258-263
Wu, Weiwei; Yang, Hailan; Feng, Yongliang et al. (2017) Polymorphisms in Inflammatory Mediator Genes and Risk of Preeclampsia in Taiyuan, China. Reprod Sci 24:539-547
Shao, Yawen; Qiu, Jie; Huang, Huang et al. (2017) Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China. BMC Pregnancy Childbirth 17:400
Li, Tianxin; Cao, Suzhen; Fan, Delong et al. (2016) Household concentrations and personal exposure of PM2.5 among urban residents using different cooking fuels. Sci Total Environ 548-549:6-12
Huang, Lei; Lerro, Catherine; Yang, Tao et al. (2016) Maternal tea consumption and the risk of preterm delivery in urban China: a birth cohort study. BMC Public Health 16:456
Wang, Y; Zhao, N; Qiu, J et al. (2015) Folic acid supplementation and dietary folate intake, and risk of preeclampsia. Eur J Clin Nutr 69:1145-1150
Zhao, Nan; Qiu, Jie; Zhang, Yaqun et al. (2015) Ambient air pollutant PM10 and risk of preterm birth in Lanzhou, China. Environ Int 76:71-7
Wang, D; Wang, M; Cheng, N et al. (2015) Sulfur dioxide exposure and other factors affecting age at natural menopause in the Jinchuan cohort. Climacteric 18:722-32
Dai, Li; Deng, Changfei; Li, Yanhua et al. (2014) Birth weight reference percentiles for Chinese. PLoS One 9:e104779
Qiu, Jie; He, Xiaochun; Cui, Hongmei et al. (2014) Passive smoking and preterm birth in urban China. Am J Epidemiol 180:94-102

Showing the most recent 10 out of 22 publications