Abstract
Fetal exposure to particulate matter (PM) is associated with infant developmental delay likely via neuroinflammation and prefrontal cortex lesions; however, whether air-purifier usage, which can reduce indoor PM levels, is related to infant developmental delay remains unknown. We therefore examined the prospective relationship between air-purifier usage during pregnancy and infant developmental delay by analyzing 82,441 mother–infant pairs using a simple yes/no questionnaire. Developmental delays at 6 and 12 months were assessed in five areas using the Ages and Stages Questionnaire, Third Edition. A generalized linear mixed model analysis was used to derive adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) while controlling for 20 covariates. The analysis revealed that air-purifier usage was associated with developmental delays in fine motor (AOR: 0.91, 95% CI: 0.83–0.99) and problem solving (AOR: 0.83, 95% CI: 0.77–0.90) at 6 months and in communication (AOR: 0.86, 95% CI: 0.79–0.93), fine motor (AOR: 0.87, 95% CI: 0.82–0.92), problem solving (AOR: 0.83, 95% CI: 0.77–0.88), and personal–social (AOR: 0.79, 95% CI: 0.72–0.86) at 12 months. In conclusion, a negative association exists between air-purifier usage during pregnancy and infant neurodevelopmental delay that strengthens with time. Our results outline the potential role of air purifiers in inhibiting infant neurodevelopmental delay.
Highlights
Pollution is the leading environmental cause of disabilities and early death [1]
In model 1, the regression models were adjusted for maternal age, parity, smoking status, passive smoking status, folic acid intake, marital status, highest educational level, annual household income, type of residence, number of rooms in the house/apartment, materials covering the floor of the living room, and age of house/apartment building, with the region set as a random effect
Higher usage of air purifiers was generally associated with high education levels, high income, less smoking, married status, parity, and living in a newer house
Summary
Pollution is the leading environmental cause of disabilities and early death [1]. Among the different types of pollution, air pollution accounts for the most disability-adjusted life years (DALYs) in the first stage of human life [2]. Guxens et al [7] revealed that high levels of PM around mothers’ homes during pregnancy are related to alterations in brain morphology and reduced cognitive function in school-aged children. The detailed mechanisms underlying the relationship between high fetal exposure to PM and impaired child neurodevelopment remain unknown, one possible pathway possibly involved is neuroinflammation. The basis of this hypothesis is the fact that pregnancy and the first year of life are critical periods of vulnerability for human neural development [10,11]. We hypothesized that the use of air purifiers is related to intact neurodevelopment
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