Prenatal Nitrate Exposure and Childhood Asthma: Influence of Maternal Prenatal Stress and Fetal Sex.

Prenatal Nitrate Exposure and Childhood Asthma: Influence of Maternal Prenatal Stress and Fetal Sex.

Am J Respir Crit Care Med. 2017 Jun 29;:

Authors: Bose S, Chiu YM, Hsu HL, Di Q, Rosa MJ, Lee A, Kloog I, Wilson A, Schwartz J, Wright RO, Cohen S, Coull BA, Wright RJ

Abstract
RATIONALE: Impact of ambient pollution upon children's asthma may differ by sex, and exposure dose and timing. Psychosocial stress can also modify pollutant effects. These associations have not been examined for in utero ambient nitrate exposure.
OBJECTIVES: We implemented Bayesian distributed lag interaction models (BDLIMs), to identify sensitive prenatal windows for the influence of NO3- on child asthma, accounting for effect modification by sex and stress.
METHODS: Analyses included 752 mother-child dyads. Daily ambient nitrate (NO3-) exposure during pregnancy was derived using a hybrid chemical transport (Geos-Chem)/land-use regression model and natural-log (ln) transformed. Prenatal maternal stress was indexed by a negative life events (NLEs) score [high (≥3) vs. low (<3)]. The outcome was clinician-diagnosed asthma by age 6 years.
MEASUREMENTS AND MAIN RESULTS: Most mothers were Hispanic (54%) or Black (29%), had ≤high school education (66%), never smoked (80%), and reported low prenatal stress (58%); 15% of children developed asthma. BDILMs adjusted for maternal age, race, education, pre-pregnancy obesity, atopy, and smoking status identified two sensitive windows-7-19 and 33-40 weeks gestation-during which increased NO3- was associated with greater odds of asthma, specifically among boys born to mothers reporting high prenatal stress. Cumulative effects of NO3- across pregnancy were also significant in this subgroup (OR=2.64, 95%CI=1.27-5.39; per IQR increase in ln-NO3-).
CONCLUSIONS: Prenatal NO3- exposure during distinct sensitive windows was associated with incident asthma in boys concurrently exposed to high prenatal stress.

PMID: 28661182 [PubMed - as supplied by publisher]

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