A study published in Environmental Health suggests that wildfire smoke exposure during early postnatal developmental periods impact subsequent early life respiratory health. Future work should investigate specific clinical outcomes, suggest the authors.
)). Interestingly, a similar protective association was found among female children in the third trimester ), but not among male children. Though stratified analyses variously produced protective effects for different sexes at during different exposures period, no interaction of exposure with sex was observed in either cohort .
For all trimester outcomes, the various thresholds used to generate smoke-day exposure estimates generally had little effect on HR estimates, with some marginal changes in the confidence interval precision . HR did not markedly differ between term births and PTBs. Sensitivity analyses including MSA-level median household income as proxy variable for area-level SES resulted in negligible changes to the HR estimates of all models; for example, changes in HR estimates with the addition of SES to the overall models ranged from -0.001 to 0.002.Using private insurance claims data, we conducted a time-to-event analysis to estimate the association between developmental exposure to wildfire smoke and first use of respiratory medication.
Additionally, for both systemic anti-inflammatory medication and lower respiratory medication, protective effects of wildfire exposure were observed during most gestational windows. Most prominently, we observed a shorter time to first lower respiratory medication use among male children and all children during the first trimester; this finding was relatively consistent across cohort specification .
Our findings suggest a complex epidemiological relationship between gestational exposure to wildfire smoke and time to first symptoms requiring respiratory prescription use. The juxtaposition of below-null HRs during gestation with evidence in the literature suggesting that ambient air pollution is not protective indicates that this analysis may suffer from selection bias . In administrative datasets, these analyses are necessarily limited to live births, and do not capture pregnancy loss.
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