TOPLINE:

Prenatal exposure to fine particulate matter of ≤ 2.5 µm in diameter is linked to an increased risk for cerebral palsy in offspring, according to researchers from Canada. 

METHODOLOGY:

• Researchers examined the associations between prenatal exposure to ambient air pollutants and cerebral palsy in more than one million full-term births in Ontario, Canada, between 2002 and 2017.
• Prenatal exposures to fine particulate matter, nitrogen dioxide, and ozone were determined based on weekly concentrations based on the reported residential address at delivery.
• Cerebral palsy cases were identified from inpatient or outpatient diagnoses for children from birth to 18 years of age.

TAKEAWAY:

• Of 1,587,935 mother-child pairs, 3170 children (0.2%) were diagnosed with cerebral palsy.
• The risk for cerebral palsy rose by 12% for each increase of 2.7 μg/m³ in the concentration of the average prenatal fine particulate matter (95% CI, 1.03-1.21). No significant associations were found for exposure to nitrous oxide and ozone.
• Male infants had a higher risk for cerebral palsy (cumulative hazard ratio [CHR], 1.14; 95% CI, 1.03-1.26) than female infants (CHR, 1.08; 95% CI, 0.96-1.22).
• A higher exposure to fine particulate matter increased the risk for cerebral palsy throughout all gestational weeks; no specific period was observed as more susceptible to risk.

IN PRACTICE:

“The findings of this large cohort study could advance the identification of existing environmental risk factors for cerebral palsy development and better inform interventions to mitigate the potential risk of cerebral palsy during fetus development,” the authors wrote.

SOURCE:

The study was led by Yu Zhang, PhD, of the Department of Environmental Health at the Harvard T.H. Chan School of Public Health in Boston and published online on July 9, 2024, in JAMA Network Open.

LIMITATIONS:

The study did not account for potential moves in residence during pregnancy. Inability to assess specific subtypes of cerebral palsy hindered the detection of associations and vulnerability periods for certain subtypes. The findings might not apply to preterm births. Additionally, potential misclassification of outcomes from using administrative databases could have introduced bias.

DISCLOSURES:

This work was supported by the US National Institute of Environmental Health Sciences and Addressing Air Pollution Horizontal Initiative research program of Health Canada. One author reported receiving personal fees from Pfizer. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.