Association between ozone exposure during pregnancy and neurodevelopment in 2-year-old children: A cohort study

Objective To investigate the associations between ozone(O₃) exposure during pregnancy and neurodevelopment in children at 2-year-old.

Methods Based on the birth cohort established in Yuexiu Maternal and Child Health Hospital of Guangzhou since March 2017, the maximum 8-hour concentrations of O₃ during pregnancy (first, second, and third trimesters) were calculated by using the inversion model based on remote sensing satellite data according to the maternal residential address. Ages and Stages Questionnaire, Third Eidition (ASQ-3) was used to evaluate offsprings' neurodevelopment at 2 years old. Multiple linear regression and Logistic regression were performed to analyze the associations between ozone exposure during pregnancy and the neurodevelopmental domains at 2 years old.

Results The medium of maximum 8-hour concentration of O₃ during pregnancy was 89.88 μg/m³, and the maximum value of maximum 8-hour concentration of O₃ in the third trimester was 129.32 μg/m³ with an unqualified rate of 52.63%. After adjustment for confounding factors, each 10 μg/m³ increase in the maximum 8-hour O₃ concentration during pregnancy was associated with a decrease in the scores of communication (β=-8.79, 95%CI: -16.73--0.86), gross motor (β=-7.19, 95%CI: -12.14--2.23), problem-solving (β=-7.04, 95%CI: -12.52--1.56), and person-social domains (β=-8.27, 95%CI: -15.46--1.07). An increase of maximum 8-hour O₃ concentration in the third trimester was associated with a decrease in the scores of problem-solving domain (β=-1.76, 95%CI: -3.21--0.31). The higher the maximum 8-hour concentrations of O₃ during pregnancy, the higher the risks of potential developmental abnormalities in the children's gross motor and problem-solving domains, and the adjusted OR (95%CI) were 4.92 (1.29, 20.72) and 4.33 (1.10, 18.76), respectively.

Conclusion Prenatal O₃ exposure during pregnancy was associated with decreased scores of communication, gross motor, problem-solving, and person-social domains of ASQ-3 in 2-year-old children, and might also increase the risk of potential abnormal development of gross motor and problem-solving domains in 2-year-old children.