Effect of maternal ozone exposure before and during pregnancy on wheezing risk in offspring: A birth cohort study in Guangzhou, China

作者：Zhu, Sui; Chen, Guimin; Ye, Yufeng; Zhou, He; He, Guanhao; Chen, Hanwei; Xiao, Jianpeng; Hu, Jianxiong; Zeng, Fangfang; Yang, Pan; Liu, Chaoqun; He, Zhongrong; Wang, Jiong; Cao, Ganxiang; Chen, Yumeng; Feng, Hao; Ma, Wenjun; Liu, Tao^*

来源：Environmental Research, 2022, 212: 113426.

DOI：10.1016/j.envres.2022.113426

• Maternal ozone exposure
• Childhood wheezing
• Susceptible exposure window
• Birth cohort study

Ozone (O-3) exposure may lead to the development and exacerbation of asthma or wheezing in postnatal children; however, it has rarely been studied before and during pregnancy. Wheezing is one of the most common symptoms when diagnosing of asthma; thus, we investigated the associations of O-3 exposure before and during pregnancy with wheezing in preschool children and the potential susceptible exposure windows from a heavily polluted city in China. This population-based birth cohort study, which included 3725 mother-child pairs from Guangzhou, began in 2016, and the follow-up period ended on July 31, 2020. We used a spatiotemporal land-use-regression model combined with activity patterns to estimate the daily O-3 exposure levels during the pre-pregnancy period and each trimester, and wheezing was recorded by reviewing medical records. We used the Cox proportional hazard model to quantify the effects of O-3 exposure on childhood wheezing adjusted for potential confounders. No significant association was detected between pre-pregnancy exposure to O-3 and child-hood wheezing. However, increased ambient O-3 exposures throughout pregnancy and in the second trimester were positively associated with the risk of childhood wheezing, with hazard ratios (HRs) and 95% confident intervals (CIs) per interquartile range (IQR) increment of 1.22 (95% CI: 1.04-1.44) and 1.31 (95% CI: 1.09-1.58), respectively. The effects of maternal O-3 exposure on childhood wheezing risk was stronger when the exposure occurred in the warm conception season (P < 0.05). Significant childhood wheezing risk could be attributable to maternal O-3 exposure, especially during the second trimester and with warm-season conception in Guangzhou. Further cohorts of children, particularly school age children who have more robust asthma diagnoses, should be investigated in the future.

• 单位
  南方医科大学; 广东药学院; 中山大学