Prenatal fine particulate exposure and early childhood asthma: Effect of maternal stress and fetal sex

Alison Lee, Hsiao Hsien Leon Hsu, Yueh Hsiu Mathilda Chiu, Sonali Bose, Maria José Rosa, Itai Kloog, Ander Wilson, Joel Schwartz, Sheldon Cohen, Brent A. Coull, Robert O. Wright, Rosalind J. Wright

Research output: Contribution to journalArticlepeer-review

115 Scopus citations


Background: The impact of prenatal ambient air pollution on child asthma may be modified by maternal stress, child sex, and exposure dose and timing. Objective: We prospectively examined associations between coexposure to prenatal particulate matter with an aerodynamic diameter of less than 2.5 microns (PM 2.5 ) and maternal stress and childhood asthma (n = 736). Methods: Daily PM 2.5 exposure during pregnancy was estimated using a validated satellite-based spatiotemporally resolved prediction model. Prenatal maternal negative life events (NLEs) were dichotomized around the median (high: NLE ≥ 3; low: NLE < 3). We used Bayesian distributed lag interaction models to identify sensitive windows for prenatal PM 2.5 exposure on children's asthma by age 6 years, and determine effect modification by maternal stress and child sex. Results: Bayesian distributed lag interaction models identified a critical window of exposure (19-23 weeks' gestation, cumulative odds ratio, 1.15; 95% CI, 1.03-1.26; per interquartile range [1.7 μg/m 3 ] increase in prenatal PM 2.5 level) during which children concomitantly exposed to prenatal PM 2.5 and maternal stress had increased risk of asthma. No significant association was seen in children born to women reporting low prenatal stress. When examining modifying effects of prenatal stress and fetal sex, we found that boys born to mothers with higher prenatal stress were most vulnerable (19-21 weeks' gestation; cumulative odds ratio, 1.28; 95% CI, 1.15-1.41; per interquartile range increase in PM 2.5 ). Conclusions: Prenatal PM 2.5 exposure during sensitive windows is associated with increased risk of child asthma, especially in boys concurrently exposed to elevated maternal stress.

Original languageEnglish
Pages (from-to)1880-1886
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Issue number5
StatePublished - 1 May 2018


  • Particulate matter
  • ambient air pollution
  • childhood asthma
  • negative life events
  • prenatal stress
  • sex- and temporal-specific effects

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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