Air Pollution Exposure During Pregnancy and Symptoms of Attention Deficit and Hyperactivity Disorder in Children in Europe.
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Forns Joan, Sunyer Jordi, Garcia-Esteban Raquel, Porta Daniela, Ghassabian Akhgar, Giorgis-Allemand Lise, Gong Tong, Gehring Ulrike, Sørensen Mette, Standl Marie, Sugiri Dorothee, Almqvist Catarina, Andiarena Ainara, Badaloní Chiara, Beelen Rob, Berdel Dietrich, Cesaroni Giulia, Charles Marie-Aline, Eriksen Kirsten Thorup, Estarlich Marisa, Fernandez Mariana F, Forhan Anne, Jaddoe Vincent W V, Korek Michal, Lichtenstein Paul, Lertxundi Aitana, Lopez-Espinosa Maria-Jose, Markevych Iana, de Nazelle Audrey, Raaschou-Nielsen Ole, Nieuwenhuijsen Mark, Pérez-Lobato Rocío, Philippat Claire, Slama Rémy, Tiesler Carla M T, Verhulst Frank C, von Berg Andrea, Vrijkotte Tanja, Nybo Andersen Anne-Marie, Heude Barbara, Krämer Ursula, Heinrich Joachim, Tiemeier Henning, Forastiere Francesco, Pershagen Göran, Brunekreef Bert, Guxens Mònica
Аннотация
METHODS: Air pollution concentrations (nitrogen dioxide [NO2] and particulate matter [PM]) were estimated at the birth address by land-use regression models based on monitoring campaigns performed between 2008 and 2011. We extrapolated concentrations back in time to exact pregnancy periods. Teachers or parents assessed ADHD symptoms at 3-10 years of age. We classified children as having ADHD symptoms within the borderline/clinical range and within the clinical range using validated cutoffs. We combined all adjusted area-specific effect estimates using random-effects meta-analysis and multiple imputations and applied inverse probability-weighting methods to correct for loss to follow-up.
RESULTS: We classified a total of 2,801 children as having ADHD symptoms within the borderline/clinical range, and 1,590 within the clinical range. Exposure to air pollution during pregnancy was not associated with a higher odds of ADHD symptoms within the borderline/clinical range (e.g., adjusted odds ratio [OR] for ADHD symptoms of 0.95, 95% confidence interval [CI] = 0.89, 1.01 per 10 µg/m increase in NO2 and 0.98, 95% CI = 0.80, 1.19 per 5 µg/m increase in PM2.5). We observed similar associations for ADHD within the clinical range.
CONCLUSIONS: There was no evidence for an increase in risk of ADHD symptoms with increasing prenatal air pollution levels in children aged 3-10 years. See video abstract at, http://links.lww.com/EDE/B379.