AIR POLLUTION EXPOSURE DURING PREGNANCY AND MATERNAL AND FETAL C-REACTIVE PROTEIN LEVELS. THE GENERATION R STUDY

Abstract

BACKGROUND: Exposure to air pollution has been associated with higher C-reactive protein (CRP) levels, suggesting an inflammatory response. Not much is known about this association in pregnancy. OBJECTIVES: We investigated the associations of air pollution exposure during pregnancy with maternal and fetal CRP levels in a population-based cohort study in the Netherlands. METHODS: Particulate matter (PM) with an aerodynamic diameter 8 mg/L) in the first trimester [fourth PM(10) quartile for the prior week: odds ratio (OR), 1.32; 95% confidence interval (CI): 1.08, 1.61; third PM(10) quartile for the prior 2 weeks: OR, 1.28; 95% CI: 1.06, 1.56]; however, no clear dose-response relationships were observed. PM(10) and NO(2) exposure levels for 1, 2, and 4 weeks preceding delivery were not consistently associated with fetal CRP levels at delivery. Higher long-term PM(10) and NO(2) exposure levels (total pregnancy) were associated with elevated fetal CRP levels (> 1 mg/ L) at delivery (fourth quartile PM(10): OR, 2.18; 95% CI: 1.08, 4.38; fourth quartile NO(2): OR, 3.42; 95% CI: 1.36, 8.58; p-values for trend < 0.05). CONCLUSIONS: Our results suggest that exposure to air pollution during pregnancy may lead to maternal and fetal inflammatory responses.