@article {4444,
	title = {Autism spectrum disorder and particulate matter air pollution before, during, and after pregnancy: a nested case-control analysis within the Nurses{\textquoteright} Health Study II Cohort.},
	journal = {Environ Health Perspect},
	volume = {123},
	number = {3},
	year = {2015},
	month = {2015 Mar},
	pages = {264-70},
	abstract = {BACKGROUND: Autism spectrum disorder (ASD) is a developmental disorder with increasing prevalence worldwide, yet has unclear etiology.

OBJECTIVE: We explored the association between maternal exposure to particulate matter (PM) air pollution and odds of ASD in her child.

METHODS: We conducted a nested case-control study of participants in the Nurses{\textquoteright} Health Study II (NHS II), a prospective cohort of 116,430 U.S. female nurses recruited in 1989, followed by biennial mailed questionnaires. Subjects were NHS II participants{\textquoteright} children born 1990-2002 with ASD (n = 245), and children without ASD (n = 1,522) randomly selected using frequency matching for birth years. Diagnosis of ASD was based on maternal report, which was validated against the Autism Diagnostic Interview-Revised in a subset. Monthly averages of PM with diameters <= 2.5 μm (PM2.5) and 2.5-10 μm (PM10-2.5) were predicted from a spatiotemporal model for the continental United States and linked to residential addresses.

RESULTS: PM2.5 exposure during pregnancy was associated with increased odds of ASD, with an adjusted odds ratio (OR) for ASD per interquartile range (IQR) higher PM2.5 (4.42 μg/m3) of 1.57 (95\% CI: 1.22, 2.03) among women with the same address before and after pregnancy (160 cases, 986 controls). Associations with PM2.5 exposure 9 months before or after the pregnancy were weaker in independent models and null when all three time periods were included, whereas the association with the 9 months of pregnancy remained (OR = 1.63; 95\% CI: 1.08, 2.47). The association between ASD and PM2.5 was stronger for exposure during the third trimester (OR = 1.42 per IQR increase in PM2.5; 95\% CI: 1.09, 1.86) than during the first two trimesters (ORs = 1.06 and 1.00) when mutually adjusted. There was little association between PM10-2.5 and ASD.

CONCLUSIONS: Higher maternal exposure to PM2.5 during pregnancy, particularly the third trimester, was associated with greater odds of a child having ASD.},
	issn = {1552-9924},
	doi = {10.1289/ehp.1408133},
	author = {Raz, Raanan and Roberts, Andrea L and Lyall, Kristen and Hart, Jaime E and Just, Allan C and Laden, Francine and Weisskopf, Marc G}
}
