Air pollution during pregnancy and childhood cognitive and psychomotor development. Six European birth cohorts

Monica Guxens
Raquel Garcia-Esteban
Lise Girogis-Allemand
Joan Forns
Chiara Badaloni
Ferran Ballester
Rob Beelen
Giulia Cesaroni
Leda Chatzi
Maria de Agostini
Audrey De Nazelle
Marloes Eeftens
Mariana F. Fernandez
Ana Fernandez-Somoano
Francesco Forastiere
Ulrike Gehring
Akhgar Ghassabian
Barbara Heude
Vincent W.V. Jaddoe
Claudia Klumper
Manolis Kogevinas
Ursula Kramer
Beatice Larroque
Aitana Lertxundi
Nerea Lertxuni
Mario Murcia
Vladislav Navel
Mark Nieuwenhuijsen
Daniela Porta
Rosa Ramos
Theano Roumeliotaki
Remy Slama
Mette Sorensen
Euripides G. Stephanou
Dorothea Sugiri
Adonina Tardon
Henning Tiemeier
Carla M. Tiesler
Frank C. Verhulst
Tanja Vrijkotte


Background: Accumulating evidence from laboratory animal and human studies suggests that air pollution exposure during pregnancy affects cognitive and psychomotor development in childhood. Methods: We analyzed data from 6 European population-based birth cohorts-GENERATION R (The Netherlands), DUISBURG (Germany), EDEN (France), GASPII (Italy), RHEA (Greece), and INMA (Spain)-that recruited mother-infant pairs from 1997 to 2008. Air pollution levels-nitrogen oxides (NO2, NOx) in all regions and particulate matter (PM) with diameters of < 2.5, < 10, and 2.5-10 [mu]m (PM2.5, PM10, and PMcoarse, respectively) and PM2.5 absorbance in a subgroup-at birth addresses were estimated by land-use regression models, based on monitoring campaigns performed primarily between 2008 and 2011. Levels were back-extrapolated to exact pregnancy periods using background monitoring sites. Cognitive and psychomotor development was assessed between 1 and 6 years of age. Adjusted region-specific effect estimates were combined using random-effects meta-analysis. Results: A total of 9482 children were included. Air pollution exposure during pregnancy, particularly NO2, was associated with reduced psychomotor development (global psychomotor development score decreased by 0.68 points [95% confidence interval = -1.25 to -0.11] per increase of 10 [mu]g/m3 in NO2). Similar trends were observed in most regions. No associations were found between any air pollutant and cognitive development. Conclusions: Air pollution exposure during pregnancy, particularly NO2 (for which motorized traffic is a major source), was associated with delayed psychomotor development during childhood. Due to the widespread nature of air pollution exposure, the public health impact of the small changes observed at an individual level could be considerable.