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Hyunok Choi,^1* Virginia Rauh,¹ Robin Garfinkel,¹ Yihsuan Tu,² and Frederica P. Perera¹

¹Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York, USA; ²Department of Statistics, National Cheng Kung University, Tainan, Taiwan

Abstract
Background: Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous air pollutants generated by combustion of organic material, including fossil fuel.

Objectives: It has been an open question whether prenatal exposure to air pollution in general and PAHs in particular significantly increases the risk of intrauterine growth restriction, including small size for gestational age (SGA) , and preterm delivery. Here, we have examined this hypothesis in a cohort of mothers and newborns in New York City.

Methods: Subjects were young, nonsmoking, healthy African-American (n = 224) and Dominican (n = 392) mother–newborn pairs residing in New York City whose prenatal PAH exposures were estimated by personal air monitoring. Questionnaire and medical record data were obtained.

Results: A 1 natural-log (ln) -unit increase in prenatal PAH exposure was associated with a 2-fold increase in risk of symmetric intrauterine growth restriction (i.e., SGA and fetal growth ratio < 85%) among full-term African Americans (p < 0.05) . Preterm delivery risk was 5-fold greater among African Americans per ln-unit increase in prenatal PAH exposure. The same unit increase in exposure significantly increased the ratio of head circumference to birth weight by 0.04% in African Americans. These effects were not observed in Dominicans.

Conclusion: Prenatal PAH exposure is likely to contribute to the occurrence of SGA as well as preterm births among African Americans. The lack of an association in Dominicans might reflect modification of the risk by healthful cultural practices among recent Dominican immigrants. Given that PAHs are globally generated and distributed pollutants, our observations have potential implications for environmental health and energy policies.

Key words: air pollution, cephalization index, fetal growth ratio, large for gestational age, polycyclic aromatic hydrocarbons, ponderal index, preterm birth, small for gestational age, symmetric intrauterine growth restriction. Environ Health Perspect 116:658–665 (2008) . doi:10.1289/ehp.10958 available via http://dx.doi.org/ [Online 30 January 2008]

Address correspondence to F.P. Perera, Columbia University, 100 Haven Ave., #25F, Tower 3, New York, NY 10032 USA. Telephone: (212) 304-7280. Fax: (212) 544-1943. E-mail: fpp1@columbia.edu

*Current address: Harvard School of Public Health, Department of Environmental Health Sciences, Program on EER, 401 Park Dr., Room 408A, Boston, MA 02155, USA.

E. Evans, R. Whyatt, H. Andrews, L. Hoepner, M. Borjas, D. Diaz, X. Jin, X. Jing, J. Lai, H. Lu, B. Plaza, C. Pulgarin, L. Qu, J. Ramirez, A. Reyes, M. Reyes, D. Tang, and J. Yu contributed to this study.

This work was supported by the National Institute of Environmental Health Sciences (grants 5 P01 ES009600, R01ES014939, 5 R01 ES008977, 5 R01ES11158, 5 R01 ES012468, 5 R01ES10165) , the U.S. Environmental Protection Agency (grants R827027, 82860901, RD-832141) , National Research Service Award T32 ES 07069, the Irving General Clinical Research Center (grant RR00645) , the Irving A. Hansen Memorial Foundation, the Gladys & Roland Harriman Foundation, the National Philanthropic Trust, and the New York Community Trust.

The authors declare they have no competing financial interests.

Received 5 October 2007 ; accepted 28 January 2008.