Prenatal air pollution exposure linked to childhood lung function

Asian pregnant woman in the middle of the road wears a PM2.5 dust mask to protect against pollution.

Swiss researchers concluded that increased levels of exposure to PM2.5 pollution during pregnancy can affect in utero lung development, thereby impacting lung function in childhood. Fetuses with this secondary exposure are at higher risk of decreased lung volume as well as airflow limitation, later in life. 

Jakob Usemann, MD, PhD, clinical scientist at University Children’s Hospital Zurich (UKBB), led the research team, whose findings were published in Pediatric Pulmonology. Dr. Usemann and colleagues built their new analysis on prior research that demonstrated adverse outcomes in children who are exposed to high levels of air pollution.

Jakob UsemannJakob Usemann, MD, PhDUKBB“We hypothesize that prenatal air pollution exposure is associated with stronger deficits in forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) than postnatal exposure,” said Dr. Usemann et al.

The LUIS study looked closer at moderate air pollution exposure during the prenatal period, infancy and preschool time. Data demonstrated a noticeable correlation between prenatal air pollution exposure and weakened pulmonary function, particularly in younger school age children. The team did not find associations between postnatal exposure to PM2.5 or NO2 and diminished lung function.

The researchers assessed 2,182 Zurich schoolchildren, ages six to 17 years, between 2013 and 2016. Subjects and their parents completed digital surveys, while investigators gathered basic measurements of the children and administered spirometry tests to collect values, including FEV1, FVC, FEV1/FVC ratio and FEF25%-75%. 

The team used geocoding to connect levels of residential NO2 and PM2.5 to the children’s locations to estimate potential pollution-related outcomes. Additional elements, such as socioeconomic status, ethnicity, body mass index and incidence of asthma or other respiratory conditions, were factored into the estimate. 

“This study further benefits from novel fine-scale prediction models incorporating information from several monitoring stations as well as satellite data, land use and meteorological parameters, enabling us to define precise and individual air pollution estimates,” the authors wrote.

Limitations to the study included the cross-sectional design and spirometry-based assessments, excluding lung growth measurements or static lung volumes. Still, the innovative study holds value for further research. 

“Our results support that there is no safe level of air pollution, and further stringent air pollution policies emissions are required to protect the respiratory health of children and adults,” the researchers said. 

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