{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:25:55Z","timestamp":1790238355576,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012537","name":"Ditmanson Medical Foundation Chia-Yi Christian Hospital","doi-asserted-by":"publisher","award":["SCRPFG031"],"award-info":[{"award-number":["SCRPFG031"]}],"id":[{"id":"10.13039\/501100012537","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Exposure to air pollution during pregnancy leads to adverse pregnancy outcomes. Few studies have evaluated the influences of air quality, including environmental tobacco smoke (ETS) and particulate matter (PM), on fetal development, which this study examined. This longitudinal correlation study used multiple linear regression data analysis of PM2.5\/PM10, self-reported ETS exposure, urinary cotinine level, maternal characteristics, and birth parameters (gestational week, body weight, body length, head, and chest circumferences) with the effect of air quality on fetal growth. The study included 74 pregnant women (mean age 31.9 \u00b1 4.2 years, body mass index 23.6 \u00b1 3.8 kg\/m2, average gestational duration 38.5 \u00b1 0.8 weeks). ETS exposure decreased birth length by \u22651 cm, and potentially is an independent risk factor for fetal growth restriction, and pregnant women should avoid indoor and outdoor ETS. However, neither PM2.5\/PM10 nor ETS was associated with low birth weight or small for gestational age. This study adds to the evidence base that ETS exposure of nonsmoking pregnant women affects the fetal birth length. Family members should refrain from smoking near expectant mothers, although smoking in the vicinity of their residential surroundings potentially exposes mothers and their fetuses to ETS. Public pollution and childbirth education classes should include details of indoor ETS.<\/jats:p>","DOI":"10.3390\/ijerph17155319","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T11:26:01Z","timestamp":1595503561000},"page":"5319","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Influence of Environmental Tobacco Smoke and Air Pollution on Fetal Growth: A Prospective Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3056-9524","authenticated-orcid":false,"given":"Meiman Maggie","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), Chiayi County, Puzi 613016, Taiwan"},{"name":"Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), Chiayi County, Puzi 613016, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9800-2677","authenticated-orcid":false,"given":"Chun-Hui","family":"Chiu","sequence":"additional","affiliation":[{"name":"Research Center for Chinese Herbal Medicine and Research Center for Food and Cosmetic Safety, Graduate Institute of Health Industry and Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan 333324, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Pin","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi County, Chiayi 600566, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Chi","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi County, Chiayi 600566, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8521-5331","authenticated-orcid":false,"given":"Su-Er","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), Chiayi County, Puzi 613016, Taiwan"},{"name":"Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), Chiayi County, Puzi 613016, Taiwan"},{"name":"Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi County, Puzi 613016, Taiwan"},{"name":"Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, New Taipei 243303, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2006). 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