Prenatal ambient air pollutant mixture exposure and neurodevelopment in urban children in the Northeastern United States

Yueh Hsiu Mathilda Chiu, Ander Wilson, Hsiao Hsien Leon Hsu, Harris Jamal, Nicole Mathews, Itai Kloog, Joel Schwartz, David C. Bellinger, Naim Xhani, Robert O. Wright, Brent A. Coull, Rosalind J. Wright

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Studies of prenatal air pollution (AP) exposure on child neurodevelopment have mostly focused on a single pollutant. We leveraged daily exposure data and implemented novel data-driven statistical approaches to assess effects of prenatal exposure to a mixture of seven air pollutants on cognitive functioning in school-age children from an urban pregnancy cohort. Methods: Analyses included 236 children born at ≥37 weeks gestation. Maternal prenatal daily exposure levels for nitrogen dioxide (NO2), ozone (O3), and constituents of fine particles [elemental carbon (EC), organic carbon (OC), nitrate (NO3), sulfate (SO42−), ammonium (NH4+)] were estimated based on residential addresses using validated satellite-based hybrid models or global 3-D chemical-transport models. Children completed Wide Range Assessment of Memory and Learning (WRAML-2) and Conners’ Continuous Performance Test (CPT-II) at 6.5 ± 0.9 years of age. Time-weighted levels for mixture pollutants were estimated using Bayesian Kernel Machine Regression Distributed Lag Models (BKMR-DLMs), with which we also explored the interactions in the exposure-response functions among pollutants. Resulting time-weighted exposure levels were used in Weighted Quantile Sum (WQS) regressions to examine AP mixture effects on outcomes, adjusted for maternal age, education, child sex, and prenatal temperature. Results: Mothers were primarily ethnic minorities (81% Hispanic and/or black) reporting ≤12 years of education (68%). Prenatal AP mixture (per unit increase in WQS estimated AP index) was associated with decreased WRAML-2 general memory (GM; β = −0.64, 95%CI = −1.40, 0.00) and memory-related attention/concentration (AC; β = −1.03, 95%CI = −1.78, −0.27) indices, indicating poorer memory functioning, as well as increased CPT-II omission errors (OE; β = 1.55, 95%CI = 0.34, 2.77), indicating increased attention problems. When stratified by sex, association with AC index was significant among girls, while association with OE was significant among boys. Traffic-related pollutants (NO2, OC, EC) and SO42− were major contributors to these associations. There was no significant evidence of interactions among mixture components. Conclusions: Prenatal exposure to an AP mixture was associated with child neurocognitive outcomes in a sex- and domain-specific manner.

Original languageEnglish
Article number116394
JournalEnvironmental Research
StatePublished - 15 Sep 2023
Externally publishedYes


  • Air pollution
  • Attention
  • Children
  • Memory
  • Mixture
  • Prenatal exposure

ASJC Scopus subject areas

  • General Environmental Science
  • Biochemistry


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