Early-Life Environmental Exposures and Blood Pressure in Children

Background: Growing evidence exists about the fetal and environmental origins of hypertension, but mainly limited to single-exposure studies. The exposome has been proposed as a more holistic approach by studying many exposures simultaneously. Objectives: This study aims to evaluate the association between a wide range of prenatal and postnatal exposures and blood pressure (BP) in children. Methods: Systolic and diastolic BP were measured among 1277 children from the European HELIX cohort at age 6–11 years. Prenatal (n=89) and postnatal (n=128) exposures include air pollution, built environment, meteorology, natural spaces, traffic, noise, chemicals, and lifestyles. Two methods adjusted for confounders were applied: an exposome-wide association study considering the exposures independently, and the deletion-substitution-addition algorithm considering all the exposures simultaneously. Results: Decreases in systolic BP were observed with facility density (β[95% CI] mmHG change for an interquartile-range increase in exposure: −1.7[−2.5;−0.8]), maternal concentrations of polychlorinated biphenyl 118 (−1.4[−2.6;−0.2]) and child concentrations of dichlorodiphenyldichloroethylene (DDE: −1.6[−2.4;−0.7]), hexachlorobenzene (−1.5[−2.4;−0.6]), and mono-benzyl phthalate (−0.7[−1.3;−0.1]), while increases in systolic BP were observed with outdoor temperature during pregnancy (1.6[0.2;2.9]), high fish intake during pregnancy (2.0[0.4;3.5]), maternal cotinine concentrations (1.2[−0.3;2.8]), and child perfluorooctanoate concentrations (0.9[0.1;1.6]). Decreases in diastolic BP were observed with outdoor temperature at examination (−1.4[−2.3;−0.5]) and child DDE concentrations (−1.1[−1.9;−0.3]) while increases in diastolic BP were observed with maternal bisphenol-A concentrations (0.7[0.1;1.4]), high fish intake during pregnancy (1.2[−0.2;2.7]), and child copper concentrations (0.9[0.3;1.6]). Conclusion: This study suggests that early-life exposure to several chemicals, as well as built environment and meteorological factors, may affect BP in children.