Pre- and postnatal particulate matter exposure and blood pressure in children and adolescents: A systematic review and meta-analysis
Abstract
Background Early life is a susceptible period of air pollution-related adverse health effects. Hypertension in children might be life-threatening without prevention or treatment. Nevertheless, the causative association between environmental factors and childhood hypertension was limited. In the light of particulate matter (PM) as an environmental risk factor for cardiovascular diseases, this study investigated the association of pre- and postnatal PM exposure with blood pressure (BP) and hypertension among children and adolescents. Method Four electronic databases were searched for related epidemiological studies published up to September 13, 2022. Stata 14.0 was applied to examine the heterogeneity among the studies and evaluate the combined effect sizes per 10 μg/m 3 increase of PM by selecting the corresponding models. Besides, subgroup analysis, sensitivity analysis, and publication bias test were also conducted. Results Prenatal PM 2.5 exposure was correlated with increased diastolic blood pressure (DBP) in offspring [1.14 mmHg (95% CI: 0.12, 2.17)]. For short-term postnatal exposure effects, PM 2.5 (7-day average) was significantly associated with systolic blood pressure (SBP) [0.20 mmHg (95% CI: 0.16, 0.23)] and DBP [0.49 mmHg (95% CI: 0.45, 0.53)]; and also, PM 10 (7-day average) was significantly associated with SBP [0.14 mmHg (95% CI: 0.12, 0.16)]. For long-term postnatal exposure effects, positive associations were manifested in SBP with PM 2.5 [β = 0.44, 95% CI: 0.40, 0.48] and PM 10 [β = 0.35, 95% CI: 0.19, 0.51]; DBP with PM 1 [β = 0.45, 95% CI: 0.42, 0.49], PM 2.5 [β = 0.31, 95% CI: 0.27, 0.35] and PM 10 [β = 0.32, 95% CI: 0.19, 0.45]; and hypertension with PM 1 [OR = 1.43, 95% CI: 1.40, 1.46], PM 2.5 [OR = 1.65, 95% CI: 1.29, 2.11] and PM 10 [OR = 1.26, 95% CI: 1.09, 1.45]. Conclusion Both prenatal and postnatal exposure to PM can increase BP, contributing to a higher prevalence of hypertension in children and adolescents.
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Prenatal PM2.5 exposure is associated with higher blood pressure in childhood and adolescence.
“Across studies that consider both prenatal and postnatal periods, prenatal particulate matter 2.5 (PM2.5) has been associated with higher BP in childhood and adolescence, suggesting that in utero exposure represents one component of a broader, cumulative exposure history [82].”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [82]
In utero PM2.5 exposure represents one component of a broader cumulative exposure history.
“Across studies that consider both prenatal and postnatal periods, prenatal particulate matter 2.5 (PM2.5) has been associated with higher BP in childhood and adolescence, suggesting that in utero exposure represents one component of a broader, cumulative exposure history [82].”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [82]
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Positive Impacts of Air Pollution Reduction on SDG 3 Targets in Urban Environment
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Environmental exposures and pediatric kidney health
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Serum level of dioxin-like polychlorinated biphenyls and blood pressure in primary school children
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P09-14 Health Impact of PM2.5 on Pregnant women and Children: Systematic Review
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Developing air quality health index: A systematic review of concepts and approaches
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Ambient particulate matter exposure and children's blood pressure in rural California, 2019-2022
Kamai, E. M., Barahona, D. D., Eckel, S. P., Olmedo, L., Bejarano, E., Torres, C., Zuidema, C., Seto, E., Johnston, J. E., & Farzan, S. F. (2026) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2026.114923
- Authors
- Liu, Y., Li, Y., Xu, H., Zhao, X., Zhu, Y., Zhao, B., Yao, Q., Duan, H., Guo, C., & Li, Y.
- Affiliations
- Capital Medical University (CN)
- Chinese Center For Disease Control and Prevention (CN)
- Corresponding author
- Li, Yan
- Guo, Caixia
- Li, Yanbo
- Venue
- Environmental Research
- Publisher
- Elsevier BV
- Published
- 2023-04
- Volume
- 223
- Pages
- 115373
- ISSN
- 0013-9351 (ISSN-L)
- OpenAlex
- W4318563449
- Cited by
- 21
- References
- 82
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 6 · 2023: 1
- FWCI
- 0.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Environmental Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Key Research and Development Program of China (2017YFC0211600, 2017YFC0211604)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Sociology and Political Science › Environmental Justice and Health Disparities
- Keywords
- particulate matter, PM2.5, PM10, prenatal air pollution exposure, pediatric hypertension, blood pressure, systolic blood pressure, diastolic blood pressure, children and adolescents, air pollution health effects, PM2.5/PM10 ratio
- MeSH terms
- Adolescent, Air Pollutants, Air Pollution, Blood Pressure, Child, Environmental Exposure, Female, Humans, Hypertension, Pregnancy, Particulate Matter
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