Abstract
Prenatal ozone (O(3)) exposure may disrupt normal offspring growth. However, epidemiological evidence that prenatal O(3) exposure affects the physical development of offspring early in life is far from adequate. A total of 4909 maternal-child pairs from the Shanghai Maternal-Child Pairs Cohort were included. A high-resolution random forest model was utilized to evaluate prenatal exposure levels of O(3) based on the home addresses of pregnant women. Group-based trajectory and mixed-effects models were used to assess associations between prenatal O(3) exposure and physical parameters. Each 10 μg/m³ increase in O(3) concentration was associated with 0.084, 0.048, and 0.082-unit increases in body mass index (BMI) for age Z score (BAZ), weight for age Z score (WAZ), and weight for length Z score (WLZ), respectively. Specifically, a 10 μg/m³ increase in O(3) concentration was linked to a 1.208-fold and 1.209-fold increase in the elevated-increasing group for the BAZ and WLZ trajectories, respectively. Moreover, each 10 μg/m³ increases in prenatal O(3) was associated with a 1.396-fold and 0.786-fold increase in the risk of BAZ- and length for age Z score (LAZ)-accelerated growth, respectively. Furthermore, a 10 μg/m³ increase in prenatal O(3) was linked to a 1.355-fold increase in the risk of overweight and obesity (OAO). Our study revealed that prenatal O(3) exposure is associated with accelerated BMI gain or decelerated body length gain in the early life of children. Prenatal O(3) may also increase the risk of OAO in children for the first two years.