ArticleJournal of exposure science & environmental epidemiology2026
Joint impact of prenatal polycyclic aromatic hydrocarbons, anxiety and depression exposure on birth outcomes across pre-pregnancy BMI categories.
Article in Journal of exposure science & environmental epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWhile polycyclic aromatic hydrocarbons (PAHs) and maternal psychological distress (anxiety/depression) are risk factors for adverse birth outcomes, their joint effects remain poorly understood, particularly across different pre-pregnancy BMI categories.
objectiveTo examine the individual and combined effects of prenatal PAHs exposure and maternal psychological distress on birth outcomes, with emphasis on effect modification by pre-pregnancy BMI.
methodsIn this prospective cohort study, we enrolled 699 pregnant women from two primary hospitals in Hefei, China, from April 2020 through October 2022. Urinary PAHs were assessed using gas chromatography tandem triple quadrupole mass spectrometry (GC-MS/MS). Anxiety and depression symptoms were assessed via Generalized Anxiety Disorder Scale (GAD-7) and Edinburgh Postnatal Depression Scale (EPDS), respectively. Logistic regression and BKMR models were used to explore the individual and combined effects of prenatal PAHs exposure and psychological distress on birth outcomes.
resultsLogistic regression revealed significant associations between PAHs and anxiety symptoms with adverse birth outcomes. In the overall population, 1-OHPHe is significantly associated with low birth weight (LBW) (OR: 2.21, 95% CI: 1.25, 4.03), 2-OHDBF and 2-OHPHe were significantly associated with preterm birth (PTB), respectively (1.43, 95% CI: 1.04, 1.98; 1.38, 95% CI: 1.02, 1.90). GAD-7 score in the third tertile was positively linked to macrosomia (OR: 3.27, 95% CI: 1.28, 10.06). BKMR demonstrated that among pre-pregnancy overweight/obese women (BMI ≧ 24.0), combined exposure to PAHs, depression, and anxiety was positively associated with LBW. Meanwhile, among the women with normal pre-pregnancy BMI (18.5-23.9), combined exposure was positively associated with macrosomia and PTB. SIGNIFICANCE: Study results indicate that combined exposure to PAHs, anxiety, and depression increases the risk of adverse birth outcomes in pregnant women. IMPACT: This study provides novel evidence that prenatal coexposure to PAHs and psychological distress differentially impacts birth outcomes based on maternal BMI. Our findings underscore the importance of considering both chemical and non-chemical stressors in prenatal care, particularly for at-risk subpopulations. These results inform targeted interventions to improve birth outcomes.
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