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Peer-reviewedCC BYEnvironmental science & technology

Preconception, Prenatal and Postnatal PM2.5 Exposure and Neurodevelopmental Disorder Risk among Medicaid Recipients.

  • Matthew Shupler1
  • Xinye Qiu2,3,4
  • Krista F Huybrechts5
  • Sonia Hernandez-Diaz1
  • Wanyu Huang2
  • Hayon Michelle Choi2
  • Michael Leung2
  • Yaguang Wei6
  • Joel Schwartz1,2
  • Brent Coull7
  • Evgenia Papatheodorou8
  • Christopher J McDougle9,10
3 more authors
  • Antonella Zanobetti2
  • Marc Weisskopf1,2
  • Stefania Papatheodorou11
11 affiliations
  1. 1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts02115, United States.
  2. 2Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts02115, United States.
  3. 3Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts02215, United States.
  4. 4Department of Medicine, Harvard Medical School, Boston, Massachusetts02115, United States.
  5. 5Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts02115, United States.
  6. 6Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, New York10029, United States.
  7. 7Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts02115, United States.
  8. 8University Hospital of Ioannina, Department of Psychiatry, Ioannina455 00, Greece.
  9. 9Lurie Center for Autism, Massachusetts General Hospital, Lexington, Massachusetts02421, United States.
  10. 10Department of Psychiatry, Harvard Medical School, Boston, Massachusetts02155, United States.
  11. 11Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey08854, United States.
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Abstract

Evidence linking ambient fine particulate matter (PM2.5) exposure to childhood neurodevelopmental disorders (NDDs) remains mixed. We conducted a cohort study (2001-2013) of 1,547,244 Medicaid-enrolled mother-child pairs to assess associations between zip-code-level PM2.5 exposure during preconception (12-week), prenatal (37-week), and postnatal (3-year) periods and children's NDD risk. Cox proportional hazards models estimated risks of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), learning difficulty (LD), speech/language disorder, developmental coordination disorder (DCD), intellectual disability, and behavioral disorder, adjusting for demographics, meteorological characteristics, and area-level socioeconomic indicators. Distributed lag models assessed critical exposure windows and cumulative effects. A 10 μg/m3 increase in cumulative prenatal PM2.5 exposure was associated with higher ASD risk (Hazard ratio (HR):1.17; 95%CI:1.00,1.37). A critical exposure window for ASD existed during gestational weeks 23-31 (HR:1.09 95%CI:[1.02,1.17]). Cumulative prenatal PM2.5 exposure was associated with increased ID risk among Hispanic individuals (HR:1.57 95%CI:[1.02,2.43]) but not among other races/ethnicities. Postnatal PM2.5 exposure was associated with increased ADHD risk (HR:1.17 95%CI:[0.94,1.46]) at age 0 years and DCD risk (HR:1.72 95%CI:[0.97,3.07]) at age 1 year. No associations between PM2.5 exposure and other NDDs were found. Prenatal and postnatal PM2.5 exposure may increase the risk of some NDDs among low-income U.S. children.

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Cite

BibTeXRIS
BibTeX
@article{shupler2026preconception,
  title = {{Preconception, Prenatal and Postnatal PM2.5 Exposure and Neurodevelopmental Disorder Risk among Medicaid Recipients.}},
  author = {Matthew Shupler and Xinye Qiu and Krista F Huybrechts and Sonia Hernandez-Diaz and Wanyu Huang and Hayon Michelle Choi and Michael Leung and Yaguang Wei and Joel Schwartz and Brent Coull and Evgenia Papatheodorou and Christopher J McDougle and Antonella Zanobetti and Marc Weisskopf and Stefania Papatheodorou},
  journal = {Environmental science \& technology},
  year = {2026},
  month = oct,
  doi = {10.1021/acs.est.6c03766},
  url = {https://europepmc.org/article/MED/42915978},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Preconception, Prenatal and Postnatal PM2.5 Exposure and Neurodevelopmental Disorder Risk among Medicaid Recipients.
AU  - Matthew Shupler
AU  - Xinye Qiu
AU  - Krista F Huybrechts
AU  - Sonia Hernandez-Diaz
AU  - Wanyu Huang
AU  - Hayon Michelle Choi
AU  - Michael Leung
AU  - Yaguang Wei
AU  - Joel Schwartz
AU  - Brent Coull
AU  - Evgenia Papatheodorou
AU  - Christopher J McDougle
AU  - Antonella Zanobetti
AU  - Marc Weisskopf
AU  - Stefania Papatheodorou
PY  - 2026
DA  - 2026/10/01
JO  - Environmental science & technology
DO  - 10.1021/acs.est.6c03766
UR  - https://europepmc.org/article/MED/42915978
AB  - Evidence linking ambient fine particulate matter (PM2.5) exposure to childhood neurodevelopmental disorders (NDDs) remains mixed. We conducted a cohort study (2001-2013) of 1,547,244 Medicaid-enrolled mother-child pairs to assess associations between zip-code-level PM2.5 exposure during preconception (12-week), prenatal (37-week), and postnatal (3-year) periods and children's NDD risk. Cox proportional hazards models estimated risks of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), learning difficulty (LD), speech/language disorder, developmental coordination disorder (DCD), intellectual disability, and behavioral disorder, adjusting for demographics, meteorological characteristics, and area-level socioeconomic indicators. Distributed lag models assessed critical exposure windows and cumulative effects. A 10 μg/m3 increase in cumulative prenatal PM2.5 exposure was associated with higher ASD risk (Hazard ratio (HR):1.17; 95%CI:1.00,1.37). A critical exposure window for ASD existed during gestational weeks 23-31 (HR:1.09 95%CI:[1.02,1.17]). Cumulative prenatal PM2.5 exposure was associated with increased ID risk among Hispanic individuals (HR:1.57 95%CI:[1.02,2.43]) but not among other races/ethnicities. Postnatal PM2.5 exposure was associated with increased ADHD risk (HR:1.17 95%CI:[0.94,1.46]) at age 0 years and DCD risk (HR:1.72 95%CI:[0.97,3.07]) at age 1 year. No associations between PM2.5 exposure and other NDDs were found. Prenatal and postnatal PM2.5 exposure may increase the risk of some NDDs among low-income U.S. children.
SN  - 0013-936X
SN  - 1520-5851
ER  -