Maternal Exposure to Fine and Coarse Particulate Matter and Congenital Malformations in Offspring Among Members of a Primary Health Care Service: A Population-Based Cohort

Abstract

Background/Aim: Studies have suggested an association between particulate matter (PM) air pollution and certain congenital anomalies. However, to date, most studies have been based on anomalies that were ascertained at birth or up to 1 year of age. We investigated associations between exposures to PM during pregnancy and congenital anomalies using birth and childhood follow-up data from a leading health care provider in Israel.Methods: We conducted a retrospective population-based cohort study among 254,756 newborns to members of the Maccabi Health Services, 2004-2015. Malformation follow-up continued into childhood. Daily fine and coarse PM data at pixels of 1X1 km2 were obtained from prediction models that incorporated satellite data. The geographic coordinates of the mother’s residence for each birth were linked to the respective pixel and averaged over weeks 3-8 of each pregnancy. As the relationship between PM and congenital anomalies was non-linear, we used quintiles of exposure to estimate adjusted odds ratios (ORs) with logistic regression models.Results: We captured 31,087 isolated anomalies in the nervous (0.5%), eye-ear-face-neck (1.7%), circulatory (3.0%), digestive (3.1%), genital (3.4%) and urinary (0.5%) systems. For fine PM, positive associations were found across all quintiles when compared to the first quintile for urinary, digestive and circulatory systems. For example, for the urinary systems ORs for the second and fifth quintiles were 1.26 (95%CI: 1.05, 1.51) and 1.14 (95%CI: 0.93, 1.39), respectively, and for the digestive system the respective ORs were 1.09 (95%CI: 1.01, 1.17) and 1.20 (95%CI: 1.11, 1.29). Negative and null associations were found across all quintiles for eye-ear-face-neck and genital anomalies, respectively. Findings for coarse PM were null or negative.Conclusions: Our results suggest supralinear concentration-response relationship between exposure to fine PM and certain congenital anomalies. Information on late diagnosis of children with congenital anomalies is important in evaluating the burden of disease.