Charline Warembourg, Léa Maitre, Ibon Tamayo-Uria, Serena Fossati, Theano Roumeliotaki, Gunn Marit Aasvang, Sandra Andrusaityte, Maribel Casas, Enrique Cequier, Lida Chatzi, Audrius Dedele, Juan-Ramon Gonzalez, Regina Gražulevičienė, Line Smastuen Haug, Carles Hernandez-Ferrer, Barbara Heude, Marianna Karachaliou, Norun Hjertager Krog, Rosemary McEachan, Mark Nieuwenhuijsen, Inga Petraviciene, Joane Quentin, Oliver Robinson, Amrit Kaur Sakhi, Rémy Slama, Cathrine Thomsen, Jose Urquiza, Marina Vafeiadi, Jane West, John Wright, Martine Vrijheid and Xavier Basagaña
Background
Growing evidence exists about the fetal and environmental origins of hypertension, but mainly limited to single-exposure studies. The exposome has been proposed as a more holistic approach by studying many exposures simultaneously.
Objectives
This study aims to evaluate the association between a wide range of prenatal and postnatal exposures and blood pressure (BP) in children.
Methods
Systolic and diastolic BP were measured among 1,277 children from the European HELIX (Human Early-Life Exposome) cohort aged 6 to 11 years. Prenatal (n = 89) and postnatal (n = 128) exposures include air pollution, built environment, meteorology, natural spaces, traffic, noise, chemicals, and lifestyles. Two methods adjusted for confounders were applied: an exposome-wide association study considering the exposures independently, and the deletion-substitution-addition algorithm considering all the exposures simultaneously.
Results
Decreases in systolic BP were observed with facility density (β change for an interquartile-range increase in exposure: −1.7 mm Hg [95% confidence interval (CI): −2.5 to −0.8 mm Hg]), maternal concentrations of polychlorinated biphenyl 118 (−1.4 mm Hg [95% CI: −2.6 to −0.2 mm Hg]) and child concentrations of dichlorodiphenyldichloroethylene (DDE: −1.6 mm Hg [95% CI: −2.4 to −0.7 mm Hg]), hexachlorobenzene (−1.5 mm Hg [95% CI: −2.4 to −0.6 mm Hg]), and mono−benzyl phthalate (−0.7 mm Hg [95% CI: −1.3 to −0.1 mm Hg]), whereas increases in systolic BP were observed with outdoor temperature during pregnancy (1.6 mm Hg [95% CI: 0.2 to 2.9 mm Hg]), high fish intake during pregnancy (2.0 mm Hg [95% CI: 0.4 to 3.5 mm Hg]), maternal cotinine concentrations (1.2 mm Hg [95% CI: -0.3 to 2.8 mm Hg]), and child perfluorooctanoate concentrations (0.9 mm Hg [95% CI: 0.1 to 1.6 mm Hg]). Decreases in diastolic BP were observed with outdoor temperature at examination (−1.4 mm Hg [95% CI: −2.3 to −0.5 mm Hg]) and child DDE concentrations (−1.1 mm Hg [95% CI: −1.9 to −0.3 mm Hg]), whereas increases in diastolic BP were observed with maternal bisphenol-A concentrations (0.7 mm Hg [95% CI: 0.1 to 1.4 mm Hg]), high fish intake during pregnancy (1.2 mm Hg [95% CI: −0.2 to 2.7 mm Hg]), and child copper concentrations (0.9 mm Hg [95% CI: 0.3 to 1.6 mm Hg]).
Conclusions
This study suggests that early-life exposure to several chemicals, as well as built environment and meteorological factors, may affect BP in children.