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Abstract
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Rising air pollution is increasingly recognized as a contributing factor to neurodevelopmental disorders, including autism. Tarragona (north-eastern province, Spain) being one of the highly polluted areas in Europe due to petrochemical industries, provides a unique context for studying the association. Therefore, the study investigates the association between prenatal air pollution exposure and autism risk in children. In the first phase of the study, out of 6894 initially recruited children with teachers-reported data, 3,727 children, along with their parents and teachers completed screening questionnaires (CAST and EDUTEA respectively). In phase 2, total 623 (58 autism, 109 autism + subthreshold autistic traits and 514 non-autism) children underwent individual clinical evaluations for autism diagnosis. Single-pollutant exposure models were analysed using multiple linear regression or logistic regression based on the outcomes to estimate β and ORs with 95% CI. Significant associations were observed between exposure to PMcoarse (β=0.16, CI: 0.03–0.29), NO2 (β=0.15, CI: 0.02–0.28), and NOₓ (β=0.18, CI: 0.03–0.34) and EDUTEA autism symptom test scores. Furthermore, we did not obtain any significant associations for any of the pollutants and risk of autism. However, additional analysis by trimester, shows higher second-trimester exposure to PM2.5 (OR=1.66, CI: 1.03–2.65) and PM10 (OR=1.46, CI: 1.01–2.12) was associated to an increased risk of autism + subthreshold autistic traits. While these findings suggest that prenatal exposure to specific air pollutants may contribute to the development to risk of autism, further research is necessary to confirm these results to reduce maternal air pollution exposure during pregnancy.
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