Association of Maternal Exposure to Fine Particulate Matter During Pregnancy with Anterior Segment Dysgenesis Risk: A Matched Case-Control Study.

Background/

Objectives

To assess the association of residential-level maternal particulate matter of 2.5 μm diameter or less (PM2.5) exposure during pregnancy with anterior segment dysgenesis (ASD) risk.

Methods

This study used data from children diagnosed with ASD (i.e., aniridia, iris hypoplasia, Peters anomaly, Axenfeld-Rieger syndrome, or primary congenital glaucoma) by an experienced pediatric ophthalmologist at a National Referral Center for Rare Diseases between 2004 and 2021 and their biological mothers. Individual PM2.5 exposure concentration was assessed by reference to residential addresses and district-specific PM2.5 concentrations predicted by the universal Kriging prediction model.

Results

The study included 2328 children (582 ASD cases and 1746 controls [1:3 matched for birth year, sex, and birth-place]). The mean (SD) annual PM2.5 exposure was 29.2 (16.9) μg/m3. An IQR increase in PM2.5 during the preconception period (11.6 μg/m3; RR, 1.18; 95% CI, 1.03-1.34), the 1st trimester (11.1 μg/m3; RR, 1.15; 95% CI, 1.03-1.27), and the 2nd trimester (11.2 μg/m3; RR 1.14; 95% CI, 1.01-1.29) significantly increased ASD risk. Meanwhile, the association between IQR increase in PM2.5 during the 3rd trimester and ASD risk showed borderline significance (11.0 μg/m3; RR, 1.10; 95% CI, 0.99-1.21). An IQR increase in PM2.5 (6.9 μg/m3) from the preconception period to the 3rd trimester was associated with a significantly increased risk of ASD (RR, 1.13; 95% CI, 1.08-1.20).

Conclusions

The findings of this study suggest that PM2.5 exposure during the preconception period and pregnancy is associated with increased risk of ASD, supporting a need for further improvements in air quality to prevent congenital ocular anomalies.