Ambient Air Pollution Exposure during Pregnancy and Neurobehavioral Status at Birth

Abstract

TPS 742: Adverse birth outcomes 1, Exhibition Hall, Ground floor, August 27, 2019, 3:00 PM - 4:30 PM Toxicant exposure during pregnancy is recognized as causing adverse effects on infant neurodevelopment, with growing research implicating community air pollution. For many indicators of neurodevelopment, assessment can only be made as the infant progresses, with subtle deficits typically not measurable at birth. The Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) was developed to assess the infant’s status shortly after birth and has been shown to be a sensitive indicator with predictive validity for future status. The NNNS provides quantitative results for 13 scales: orientation, habituation, hypertonicity, excitability, arousal, lethargy, non-optimal reflexes, asymmetrical reflexes, stress, self-regulation, quality of movement, and handling. Data from the Rhode Island Child Health Study, a cohort of term births 2009-2013 in Providence, Rhode Island, US was analyzed to assess the association between estimated ambient air pollution during gestation and infant neurobehavioral health. We estimated trimester-specific residential ambient levels of black carbon and PM2.5 using satellite imaging and land-use regression models, as well as distance to major roadways. The NNNS assessment was conducted by trained research staff shortly after delivery and covariate data were collected from maternal interviews. A cohort of 309 infants with complete data on exposure, outcome, and covariates was analyzed. Adjusted odds ratios were calculated relating estimated air pollution to dichotomized NNNS scale scores. Results for all scales except attention response, arousal level, and habituation response were essentially null. There was little consistency in which pollutant and trimester were associated with these scales. These largely null results suggest that within the range of air pollution of this northeastern US city, there is unlikely to be a substantial broad impact on infant neurobehavioral health, but more selective associations between specific pollutants, times in gestation, and neurobehavioral functions are possible.