Maternal ambient exposure to atmospheric pollutants during pregnancy and offspring term birth weight in the nationwide ELFE cohort

Marion Ouidir, Emie Seyve, Emmanuel Rivière, Julien Bernard, Marie Cheminat, Jérôme Cortinovis, François Ducroz, Fabrice Dugay, Agnès Hulin, Itai Kloog, Anne Laborie, Ludivine Launay, Laure Malherbe, Pierre Yves Robic, Joel Schwartz, Valérie Siroux, Jonathan Virga, Cécile Zaros, Marie Aline Charles, Rémy SlamaJohanna Lepeule

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Studies have reported associations between maternal exposure to atmospheric pollution and lower birth weight. However, the evidence is not consistent and uncertainties remain. We used advanced statistical approaches to robustly estimate the association of atmospheric pollutant exposure during specific pregnancy time windows with term birth weight (TBW) in a nationwide study. Methods: Among 13,334 women from the French Longitudinal Study of Children (ELFE) cohort, exposures to PM2.5, PM10 (particles < 2.5 µm and <10 µm) and NO2 (nitrogen dioxide) were estimated using a fine spatio-temporal exposure model. We used inverse probability scores and doubly robust methods in generalized additive models accounting for spatial autocorrelation to study the association of such exposures with TBW. Results: First trimester exposures were associated with an increased TBW. Second trimester exposures were associated with a decreased TBW by 17.1 g (95% CI, −26.8, −7.3) and by 18.0 g (−26.6, −9.4) for each 5 µg/m3 increase in PM2.5 and PM10, respectively, and by 15.9 g (−27.6, −4.2) for each 10 µg/m3 increase in NO2. Third trimester exposures (truncated at 37 gestational weeks) were associated with a decreased TBW by 48.1 g (−58.1, −38.0) for PM2.5, 38.1 g (−46.7, −29.6) for PM10 and 14.7 g (−25.3, −4.0) for NO2. Effects of pollutants on TBW were larger in rural areas. Conclusions: Our results support an adverse effect of air pollutant exposure on TBW. We highlighted a larger effect of air pollutants on TBW among women living in rural areas compared to women living in urban areas.

Original languageEnglish
Article number5806
JournalInternational Journal of Environmental Research and Public Health
Issue number11
StatePublished - 1 Jun 2021


  • Air pollution
  • Doubly robust
  • Propensity score
  • Spatial autocorrelation
  • Term birth weight

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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