{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:42:16Z","timestamp":1793796136405,"version":"4.6.1"},"reference-count":40,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2018,5,15]],"date-time":"2018-05-15T00:00:00Z","timestamp":1526342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["NMRC\/TCR\/004-NUS\/2008; NMRC\/TCR\/012-NUHS\/2014"],"award-info":[{"award-number":["NMRC\/TCR\/004-NUS\/2008; NMRC\/TCR\/012-NUHS\/2014"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Prenatal exposure to air pollution is associated with childhood respiratory health; however, no previous studies have examined maternal pre-pregnancy body mass index (BMI) as a potential effect modifier. We investigated whether maternal pre-pregnancy BMI modified the association of trimester-specific air pollution divided into quartiles of exposure (Q1\u20134) on respiratory health in the Growing Up in Singapore towards healthy Outcomes (GUSTO) study (n = 953) in 2-year-old children. For episodes of wheezing, children of overweight\/obese mothers and who were exposed to particulate matter less than 2.5 \u03bcm (PM2.5) in the first trimester had an adjusted incidence rate ratio (IRR) (95% confidence interval (CI)) of 1.85 (1.23\u20132.78), 1.76 (1.08\u20132.85) and 1.90 (1.10\u20133.27) in quartile (Q) 2\u20134, with reference to Q1. This association is seen in the second trimester for bronchiolitis\/bronchitis. The risk of ear infection in the first year of life was associated with exposure to PM2.5 in the first trimester with adjusted Odds Ratio (adjOR) (95% CI) = 7.64 (1.18\u201349.37), 11.37 (1.47\u201387.97) and 8.26 (1.13\u201360.29) for Q2\u20134, and similarly in the second year with adjOR (95% CI) = 3.28 (1.00\u201310.73) and 4.15 (1.05\u201316.36) for Q2\u20133. Prenatal exposure to air pollution has an enhanced impact on childhood respiratory health, and differs according to maternal pre-pregnancy BMI.<\/jats:p>","DOI":"10.3390\/ijerph15050996","type":"journal-article","created":{"date-parts":[[2018,5,15]],"date-time":"2018-05-15T11:36:13Z","timestamp":1526384173000},"page":"996","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Pregnancy Trimester-Specific Exposure to Ambient Air Pollution and Child Respiratory Health Outcomes in the First 2 Years of Life: Effect Modification by Maternal Pre-Pregnancy BMI"],"prefix":"10.3390","volume":"15","author":[{"given":"Shu-E","family":"Soh","sequence":"first","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117549, Singapore"},{"name":"Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oon Hoe","family":"Teoh","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4643-0618","authenticated-orcid":false,"given":"Keith M.","family":"Godfrey","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Gluckman","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117549, Singapore"},{"name":"Liggins Institute, University of Auckland, Auckland 1023, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynette Pei-Chi","family":"Shek","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117549, Singapore"},{"name":"Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yap-Seng","family":"Chong","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117549, Singapore"},{"name":"Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,5,15]]},"reference":[{"key":"ref_1","unstructured":"(2018, April 15). 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