Postnatal exposure to PM and weight trajectories in early childhood.

Background: Inconsistent evidence has assessed the impact of air pollution exposure on children's growth trajectories. We investigated the role of 90-day average postnatal fine particulate matter (PM) exposures by estimating the magnitude of effects at different ages, and the change in child weight trajectory by categories of exposure.

Methods: We obtained weight values from electronic health records at each hospital visit (males = 1859, females = 1601) from birth to 6 years old children recruited into the Boston-based Children's HealthWatch cohort (2009-2014). We applied mixed models, adjusting for individual and maternal confounders using (1) varying-coefficient models allowing for smooth non-linear interaction between age and PM, (2) factor-smooth interaction between age and PM quartiles. Additionally, we stratified by sex and low birthweight (LBW) status (≤2500 g).

Results: Using varying-coefficient models, we found that PM significantly modified the association between age and weight in males, with a positive association in children younger than 3 years and a negative association afterwards. In boys, for each 10 µg/m increase in PM we found a 2.6% increase (95% confidence interval = 0.8, 4.6) in weight at 1 year of age and a -0.6% (95% confidence interval = -3.9, 2.9) at 5 years. We found similar but smaller changes in females, and no differences comparing growth trajectories across quartiles of PM. Most of the effects were in LBW children and null for normal birthweight children.

Conclusions: This study suggests that medium-term postnatal PM may modify weight trajectories nonlinearly in young children, and that LBW babies are more susceptible than normal-weight infants.