Abstract

BackgroundExposure to air pollution during pregnancy has been associated with adverse pregnancy outcomes in studies worldwide, other studies have described beneficial effects of residential greenspace on pregnancy outcomes. The biological mechanisms that underlie these associations are incompletely understood. A biological stress response, which implies release of cortisol, may underlie associations of air pollution exposure and access to neighborhood greenspaces with health.MethodsWe explored residential exposure to air pollution and residential access to neighborhood greenspaces in relation to hair cortisol concentrations of participants in a prospective pregnancy cohort study in Flanders, Belgium. Hair samples were collected at the end of the second pregnancy trimester (n = 133) and shortly after delivery (n = 81). Cortisol concentrations were measured in 3-cm scalp-near hair sections, to reflect second and third pregnancy trimester cortisol secretion. We estimated long-term (3 months before sampling) residential exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and black carbon (BC), assessed residential distance to major roads and residential access to neighborhood greenspaces (NHGS). Associations between residential exposures and hair cortisol concentrations were studied using linear regression models while adjusting for season of sampling.ResultsThree-month mean residential NO2 and BC concentrations were positively associated with third pregnancy trimester hair cortisol concentrations (p = 0.008 and p = 0.017). Access to a large NHGS (10 ha or more within 800 m from residence) was negatively associated with third trimester hair cortisol concentrations (p = 0.019). Access to a large NHGS significantly moderated the association between residential proximity to major roads and second trimester hair cortisol concentrations (p = 0.021). Residential distance to major roads was negatively associated with second trimester hair cortisol concentrations of participants without access to a large NHGS (p = 0.003). The association was not significant for participants with access to a large NHGS. The moderation tended towards significance in the third pregnancy trimester (p < 0.10).ConclusionsOur findings suggest a positive association between long-term residential exposure to air pollution and biological stress during pregnancy, residential access to neighborhood greenspaces may moderate the association. Further research is needed to confirm our results.Trial registrationThe IPANEMA study is registered under number NCT02592005 at clinicaltrials.gov.

Highlights

  • Exposure to air pollution during pregnancy has been associated with adverse pregnancy outcomes in studies worldwide, other studies have described beneficial effects of residential greenspace on pregnancy outcomes

  • Three-month mean residential Nitrogen dioxide (NO2) and black carbon (BC) concentrations were positively associated with third pregnancy trimester hair cortisol concentrations (p = 0.008 and p = 0.017)

  • Access to a large neighborhood greenspace (NHGS) significantly moderated the association between residential proximity to major roads and second trimester hair cortisol concentrations (p = 0.021)

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Summary

Introduction

Exposure to air pollution during pregnancy has been associated with adverse pregnancy outcomes in studies worldwide, other studies have described beneficial effects of residential greenspace on pregnancy outcomes. Epidemiological studies throughout the world have linked maternal exposure to road traffic and air pollution to adverse pregnancy outcomes such as low birth weight, preterm birth and intrauterine growth restriction [1,2,3] These adverse birth outcomes increase perinatal morbidity and mortality, and increase susceptibility to obesity, diabetes and cardiovascular diseases later in life [4, 5]. The biological stress response includes activation of the hypothalamic-pituitaryadrenal (HPA) axis and release of glucocorticoid stress hormones, with the glucocorticoid cortisol as its main downstream effector in humans [12] The relevance of these experimental observations to humans has been confirmed in a few recent studies [13, 14]. With regard to birth outcomes, a significant negative association between maternal HCC in the 2nd pregnancy trimester and gestational age at delivery has been reported [24]

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