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Prenatal NO2 exposure and ultrasound measures of foetal growth: a prospective cohort study in Wuhan, China
  1. Weiye Wang1,
  2. Chunrong Zhong2,
  3. Li Huang2,
  4. Xuezhen Zhou2,
  5. Renjuan Chen2,
  6. Jiangyue Wu2,
  7. Xiating Li2,
  8. Ting Xiong2,
  9. Chaoqun Liu2,
  10. Mei Xiao3,
  11. Xuefeng Yang2,
  12. Liping Hao2,
  13. Nianhong Yang2,
  14. Sheng Wei1
  1. 1Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
  2. 2Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
  3. 3Department of Obstetrics and Gynaecology, Hubei Maternal and Child Health Hospital, Wuhan, Hubei, People's Republic of China
  1. Correspondence to Dr Sheng Wei, Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei 430030, China; ws2008cn{at}gmail.com

Abstract

Objectives To examine the relationship between prenatal nitrogen dioxide (NO2) exposure and foetal growth in a prospective cohort of 1001 Chinese women.

Methods The maternal NO2 exposure levels were estimated using land-use regression models based on home address. The biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL) and estimated foetal weight (EFW) were evaluated via ultrasonography. The multiple linear regression model was used to adjust for confounders, and the mixed-effect model was used to assess longitudinal effect.

Results With a 10 μg/m3 increase in NO2 exposure, the BPD, HC, AC, FL and EFW in the second trimester decreased by 0.40 mm (95% CI −0.56 to −0.24), 1.07 mm (95% CI −1.60 to −0.54), 1.02 mm (95% CI −1.57 to −0.48), 0.24 mm (95% CI −0.37 to −0.12) and 7.84 g (95% CI −11.59 to −4.08), respectively; the BPD and HC in the third trimester decreased by 0.26 mm (95% CI −0.50 to −0.02) and 0.71 mm (95% CI −1.37 to −0.06), respectively. The longitudinal analyses showed inverse associations of NO2 exposure with BPD, HC, AC and FL (all p<0.05). The stratified analyses showed that the effects of NO2 on the HC, FL and EFW in the second trimester were stronger among female babies and that the effect of NO2 on EFW in the third trimester was stronger among smoking mothers (all p<0.05).

Conclusions In this prospective study of Chinese women, maternal NO2 exposure was inversely associated with foetal growth, and the association was stronger among female babies and smoking mothers.

  • nitrogen dioxide
  • fetal growth

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Footnotes

  • NY and SW contributed equally.

  • Contributors WW, SW and NY participated in conception and study design. WW and SW collected data for NO2 exposure estimation; WW, CZ, XZ, RC, XL, JW, LH, TX, CL and MX collected other data. SW, XY, LHao and NY supervised the study conduct. WW and SW contributed to the statistical analysis and wrote the manuscript. All authors have read and approved the final version of the manuscript.

  • Funding This work was supported by the National Program on Basic Research Project of China (NO.2013FY114200) for Nianhong Yang, the National Natural Science Foundation of China (NSF81172754) for Sheng Wei.

  • Competing interests None declared.

  • Ethics approval The Ethics Review Committee of Tongji Medical College, Huazhong University of Science and Technology.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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