P4.043: Prenatal Particulate Matter Exposure and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants: A Retrospective Cohort Study

Background: Previous research has predominantly focused on adverse birth outcomes, such as miscarriage, and very preterm birth, associated with maternal particulate matter (PM) exposure, but limited attention has been given to the prognosis of survival premature infants. Recently, animal studies have indicated that PM exposure during pregnancy can lead to a greater likelihood of bronchopulmonary dysplasia (BPD). However, no epidemiology studies have yet confirmed this phenomenon.The goal of this research was to assess the associations of maternal PM2.5 and PM10 exposure during pregnancy with BPD in very preterm infants.

Methods: Clinical data were collected from the electronic medical records for very preterm infants (gestational age (GA) < 32 weeks) who were hospitalized at a Children’s Hospital from January 1, 2016 to December 31, 2022. Maternal PM exposure was evaluated via comprehensive and high-resolution estimates. Data analysis involved the utilization of logistic regression models that were adjusted for additional ambient air pollutants (O3 and NO2), as well as clinical characteristics. Stratified analyses were also performed.

Results: 2,223 infants were included in this study, with 684 of them having BPD. Strong correlations were observed between PM exposure and BPD, with each interquartile range increase during the entire gestational period associated with odds ratios (OR) of 1.264 (95%CI: 1.069-1.494) for PM2.5 and 1.359 (95% CI: 1.147-1.611) for PM10 in the single-pollutant model. The strongest associations were observed during the second trimester and the same association was also identified in the two-pollutant model. Stratified analysis revealed a larger OR estimate in male infants and in subgroups with lower birth weight, smaller GA, and conception in cold season.

Conclusion: This study provides epidemiologic evidence for the influence of maternal PM exposure on BPD. These findings could inform policy formulation and enhance the understanding of the underlying mechanisms of this disease.