Prenatal wildfire smoke exposure and adverse neonatal outcomes in a high-risk cohort of pregnant women with asthma

作者：Bronwyn K. Brew, Peter G. Gibson, Adam Collison, Wilfried Karmaus, Stuart Szwec, Elizabeth Holliday, Geoffrey Morgan, Karthik Gopi, Graeme R. Zosky, Megan E. Jensen, Vanessa M. McDonald, Paul D. Robinson, Joërg Mattes, Vanessa E. Murphy · 发表于：American Journal of Obstetrics and Gynecology · 年份：2026 · DOI：10.1016/j.ajog.2026.02.022 · 被引用次数：3 · 研究领域：Air Quality and Health Impacts、Cancer Risks and Factors、Energy and Environment Impacts

BACKGROUND: Climate change is contributing to more frequent wildfires. Exposure to wildfire smoke during pregnancy increases the risk of adverse neonatal outcomes. Pregnant women with asthma and their newborns are particularly at risk of negative effects from wildfire smoke exposure and remain understudied. Determining critical windows of exposure during pregnancy could help inform mitigation strategies for this high-risk group. OBJECTIVE: This study aimed to assess the association of prenatal wildfire smoke exposure with adverse neonatal outcomes in mothers with asthma and to determine which period of pregnancy is most critical. STUDY DESIGN: This was a multicenter cohort study (Breathing for Life Trial) including mothers and newborns from 6 antenatal clinics across 4 cities in Australia (Sydney, Brisbane, Newcastle, Canberra). Pregnant women (n=1275) with asthma were recruited at 12 to 23 weeks of gestation. Chronic lung disease (other than asthma), miscarriages, and perinatal deaths were excluded. Prenatal wildfire smoke exposure days and daily wildfire-related particulate matter ≤2.5 μm concentrations were determined by residence. Exposure over pregnancy was assessed in 3 ways: (1) cumulative days of wildfire smoke (0, 1-4, 5-9, ≥10 days); (2) wildfire smoke-affected days and wildfire-related particulate matter ≤2.5 μm as continuous variables for each gestational month; and (3) a natural experiment comparing exposure during the 2019-2020 summer extreme wildfire period wit...