Significance: Once thought to be protected from outside influences, the in utero environment has been shown to be more vulnerable to exposures and insults than previously believed. In recent years, in utero air pollutant exposures have been identified as a potentially important risk factor for adverse birth outcomes and, together with postnatal exposures, developmental delays. Despite this, little is understood about the effect of air pollutant exposures on neonatal and early childhood development, particularly for low-income and minority children, who may be more susceptible to air pollution’s toxic effects. This susceptibility may be particularly significant for infants and children in Puerto Rico, who live amidst numerous and diverse pollution sources and who are known to experience high rates of adverse birth outcomes and asthma, among other adverse health conditions. However, little is known about the impact of air pollution on the health and development of Puerto Rican children. Clearly new studies are needed to assess this impact and to identify ways to reduce health risks for this vulnerable population.
To address this need, Project 1 examines the relationship between air pollution and development in a cohort of children living in Puerto Rico, who are followed from gestation through age four. We use traditional measures of adverse birth outcomes and development, such as preterm birth, respiratory, and neurodevelopmental evaluations. In addition, we measure non-nutritive suck, an established measure of newborn central nervous system function that has not previously been used to assess neonatal development in environmental epidemiological studies. We investigate the linkage between these health measures and air pollution exposures, in utero chemical exposures, and maternal and child characteristics for each child. Such a rich database allows Project 1 to examine whether ambient pollution exposure alters the developing brain, a susceptible organ that is difficult to access in a clinical evaluation. These insights enable CRECE to identify important relationships and modifiable factors affecting the development of Puerto Rican children, who are highly exposed, yet understudied.