Sex-specific influence of prenatal air pollutant exposure on neonatal neurobehavioral development and the sensitive window

Increasing evidence indicates the adverse effect of air pollution exposure during pregnancy on neurologic development among children. However, the impact on neurobehavioral development in fetus remains unknown. In 2017, a total of 1193 mother–newborns pairs were enrolled in a birth cohort study in Changsha, China. Exposures to PM2.5, PM10, SO2, CO and NO2 were determined by using inverse distance weighted method based on local monitoring station data. Neurobehavioral measure was administered at 48–72 h postpartum by utilizing the neonatal behavioral neurological assessment (NBNA). Basic information and covariates were collected by face to face interview. Generalized linear regression and multivariable restricted cubic spline function were performed to explore the trimester-specific association and dose-response relationship of maternal air pollution exposure with NBNA score, respectively. In adjusted three-pollutant model, PM2.5 exposure in trimester 2 was negatively associated with behavior score (β, −0.003; 95% CI, −0.006, −0.001) and the inverse relation was more pronounced in male infants. In addition, PM2.5 level in the 2nd trimester was negatively related to activetone score (β, −0.012; 95% CI, −0.021, −0.002) in a dose-dependent manner for both genders. Collectively, our results demonstrated that prenatal exposure to PM2.5 was linked to poor neurobehavioral performance of newborns. The second trimester was the most sensitive time window for the developments of behavior and activetone, and male subject was more vulnerable as compared to females.