Maternal exposure to ambient air pollution and fetal growth in North-East Scotland: A population-based study using routine ultrasound scans

Tom Clemens (Corresponding Author), Steve Turner, Chris Dibben

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Background Maternal ambient air pollution exposure is associated with reduced birthweight. Few studies have examined the effect on growth in utero though none have examined the effect of exposure to particulates less than 2.5 microns (PM2.5) and possible effect modification by smoking status.
Objectives Examine the effect of maternal exposure to ambient concentrations of PM10, PM2.5 and Nitrogen Dioxide (NO2) for in utero fetal growth, size at birth and effect modification by smoking status.
Methods Administratively acquired second and third trimester fetal measurements (bi-parietal diameter, femur length and abdominal circumference), birth outcomes (weight, crown heel length and occipito-frontal circumference) and maternal details were obtained from routine fetal ultrasound scans and maternity records (period 1994-2009). These were modelled against residential annual pollution concentrations (calendar year mean) adjusting for covariates and stratifying by smoking status.
Results In the whole sample (n=13,775 pregnancies), exposure to PM10, PM2.5 and NO2 ¬was associated with reductions in measurements at birth and biparietal diameter from late second trimester onwards. Among mothers who did not smoke at all during pregnancy (n=11075), associations between biparietal diameter and pollution exposure remained significant but were insignificant among those who did smoke (n=2700). Femur length and abdominal circumference were not significantly associated with pollution exposure.
Conclusions Fetal growth is strongly associated with particulates exposure from later in second trimester onwards but the effect appears to be subsumed by smoking. Typical ambient exposures in this study were relatively low compared to other studies and given this studies results, it may be necessary to consider reducing recommended “safe” ambient air exposures.
Original languageEnglish
Pages (from-to)216-226
Number of pages11
JournalEnvironment International
Early online date25 Jul 2017
Publication statusPublished - Oct 2017

Bibliographical note

The authors acknowledge the support of the Grampian Data Safe Haven (DaSH) and the associated financial support of the University of Aberdeen and NHS Research Scotland, through NHS Grampian investment in DaSH. Tom Clemens and access to the Grampian Data Safe Haven was supported by the UK Medical Research Council through the Farr Institute for Health Informatics (Reference: MR/M501633/2).


  • fetal growth
  • ambient air pollution
  • maternal health
  • in utero
  • Scotland


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