Organochlorine compounds (OCs), including pesticides and polychlorobiphenyls (PCBs), were determined in the serum of 499 cord blood samples from infants born during 2004−2006 in Valencia (Spain). The concentrations were found to be correlated with the region of origin of the mothers. Those from Latin-America gave birth to infants with higher 4,4′-DDE and 4,4′-DDT concentrations than those from Europe. On the contrary, European mothers had children with higher concentrations of hexachlorobenzene and PCBs than Latin-American mothers. These associations were independent of maternal period of stage in Valencia. Data examination with a multivariate model including maternal region of origin described 39−44% of the concentration variability of 4,4′-DDE and total PCBs with statistic significance. Other maternal variables found to significantly influence OC burden in newborns were age, education level, and body mass index (BMI). In general, older women, with higher education standards and higher BMI had infants with higher OC serum concentrations than younger women, with lower education scores and low BMI. The increase of 4,4′-DDT in newborns from mothers with high education levels and high BMI suggest that dissimilar maternal diets may be at the origin of some of these OC body burden differences. ; Spanish Ministry of Health and Ministry of Science and Innovation (INMA G03/176, Consolider Ingenio GRACCIE, CSD2007-00067, FIS-FEDER: 03/1615, 04/1112, 04/1509, 04/1666, 05/1987, 06/1213 and 09/2647), Council of Health from the Autonomous Valencian Government (Generalitat Valenciana), Fundacio Roger Torne, and ArcRisk EU Project (FP7-ENV-2008-1-226534). ; Peer reviewed
6 páginas, 2 figuras, 2 tablas. ; Polybromodiphenyl ethers (PBDEs) were analyzed in blood serum of pregnant women and in cord blood serum of their newborns from a general population cohort (n = 174; Valencia, Spain). The most abundant PBDE congeners identified were BDE 47, BDE 99, BDE 153, BDE 154 and BDE 209. Their cord blood serum concentrations were about 45% of those in maternal serum but after lipid normalization median of total PBDEs was 9.6 ng/g lipid in cord serum (concentrations encompassing between not detected and 140 ng/g lipid) and 9.6 ng/ lipid in maternal serum(concentrations covering between not detected and 120 ng/g lipid). The distributions of these compounds were dominated by BDE 47 in both cases. In cord blood serum the decreasing order of abundance was BDE 47 > BDE 99 > BDE 209 > BDE 153 > BDE 154. The congener composition in maternal serum followed a similar trend: BDE 47 > BDE 153 > BDE 154 > BDE 209 > BDE 99. The congener concentrations exhibited a higher degree of correlation in cord blood than in maternal serum. Use of the maternal determinants for categorization of the observed maternal and fetal PBDE concentrations only showed significant associations for the levels in umbilical cord. Neonates from rural areas exhibited statistically significantly lower concentrations than those from urban, semi-urban or metropolitan sites. Maternal serum also showed this difference but the higher dispersion of the concentrations in maternal serum did not afford its recognition with statistical significance. The lower qualitative and quantitative variability in the PBDE concentrations of cord blood serum than maternal serum suggest that the latter is reflecting PBDE contributions from a wider diversity of sources than the former whereas cord blood sera seems to represent the long term standing stock of these compounds accumulated in the maternal tissues. ; The authors are grateful to the mothers who participated in the study and to Hospital La Fe. Funding was received from the Spanish Ministry of Health and Ministry of Science and Innovation (INMA G03/ 176, Consolider Ingenio GRACCIE, CSD2007-00067, FIS-FEDER: 03/ 1615, 04/1112, 04/1509, 04/1666, 05/1987, 06/1213 and 09/2647), Council of Health from the Autonomous Valencian Government (Generalitat Valenciana), Fundacio Roger Torne and ArcRisk EU Project (FP7-ENV-2008-1-226534) ; Peer reviewed
11 páginas, 4 figuras, 6 tablas. ; Prenatal levels of organohalogen compounds (OHCs), including polybromodiphenyl ethers (PBDEs), polychlorobiphenyls (PCBs), hexachlorobenzene (HCB), hexachlorocyclohexanes and DDTs have been investigated in two different cohorts from the Spanish Mediterranean area, Valencia and Menorca, by analysis of cord blood serum. Comparison of the observed median concentrations to other cohorts show low PBDE levels (2.8-6.8 ng/g lipid) but high values of HCB (0.68 ng/ml, 260 ng/g lipid) and PCBs (0.65 ng/ml, 240 ng/g lipid) in the cohort of Menorca indicating that Mediterranean areas, and not only high latitude regions, may contain population groups highly exposed to some of these pollutants. Significant differences in the concentrations of these compounds have been found between the two cohorts. Differences in maternal population such as age or body mass index cannot explain this variation. One possible cause of variability is the seven year time period elapsed between the two cohort recruitments but the strong differences observed do not allow exclusion of local diet differences. Thus, the different average PCB congener distributions between the two cohorts suggests an influence from materials containing diverse PCB mixtures. The congener mixtures found in Menorca could reflect a diet contribution from some western Mediterranean fish species. These results provide baseline information on prenatal OHC background levels in the Mediterranean area. ; The authors are grateful to the mothers who participated in the study and to Hospital La Fe. Funding was received from the Spanish Ministry of Health and Ministry of Science and Innovation (INMA G03/176, Consolider Ingenio GRACCIE, CSD2007-00067, FIS-FEDER: 03/1615, 04/1112, 04/1509, 04/1666, 05/1987, 06/1213 and 09/2647), Council of Health from the Autonomous Valencian Government (Generalitat Valenciana), Fundacio Roger Torne and ArcRisk EU Project (FP7-ENV-2008-1-226534). ; Peer reviewed
Objective: Describe the risk of poverty and social exclusion in children aged 8-11 years from Gipuzkoa and Valencia (Spain), through AROPE (At Risk Of Poverty or Social Exclusion) indicators, and evaluate their associated factors in the INMA Project (Childhood and Environment). Method: Families in Gipuzkoa and Valencia (394 and 382, respectively) completed a questionnaire in 2015-2016. Low work intensity (LWI), at risk of poverty (RP) and material deprivation (MD) were estimated. AROPE consisted in meeting any of the previous sub-indicators. Socio-demographic, family and parental characteristics were considered. Frequencies, Venn's diagrams, and chi-square and Fisher tests were used in bivariate analysis and logistic regression in multivariate analysis. Results: For LWI, RP, MD and AROPE, prevalence of 2.5%, 5.6%, 2.3% and 7.2% were obtained in Gipuzkoa, and 8.1%, 31.5%, 7.8% and 34.7% in Valencia, respectively. In the multivariate analysis, the AROPE was associated in both areas with maternal social class and non-nuclear families. In Gipuzkoa, it was also related to maternal education. In Valencia, other factors were the mother's foreign origin, and paternal education and smoking. Conclusion: There is higher AROPE prevalence in Valencia. Social class and family type were shared factors, but a differential pattern is observed in other social determinants. It is essential to implement social policies to reduce this axis of inequalities in health, especially in childhood. ; This study was funded by Grants from European Union (FP7-ENV-2011 code 282957 and HEALTH.2010.2.4.5-1), Spain: Instituto de Salud Carlos III (ISCIII) (Red INMA G03/176, CB06/02/0041; FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/0867, PI06/1213, PI07/0314, PI09/00090, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI13/02187, PI14/00891, PI14/01687, PI16/1288, and PI17/00663), Generalitat Valenciana: Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat ...
8 pages, 3 tables.-- PMID: 16911019 [PubMed]. ; The INMA (INfancia y Medio Ambiente [Environment and Childhood]) is a population-based cohort study in different Spanish cities, that focuses on prenatal environmental exposures and growth, development and health from early fetal life until childhood. The study focuses on five primary areas of research: (1) growth and physical development; (2) behavioural and cognitive development; (3) asthma and allergies; (4) sexual and reproductive development; and (5) environmental exposure pathways. The general aims of the project are: (1) to describe the degree of individual prenatal exposure to environmental pollutants, and the internal dose of chemicals during pregnancy, at birth and during childhood in Spain; (2) to evaluate the impact of the exposure to different contaminants on fetal and infant growth, health and development; (3) to evaluate the role of diet on fetal and infant growth, health and development; and (4) to evaluate the interaction between persistent pollutants, nutrients and genetic determinants on fetal and infant growth, health and development ; Extensive assessments will be carried out on 3100 pregnant women and children. Data will be collected by physical examinations, questionnaires, interviews, ultrasound and biological samples. Pregnant women are being assessed at 12, 20 and 32 weeks of gestation to collect information about environmental exposures and fetal growth. The children will be followed until the age of 4 years. ; We are grateful to all the mothers, their partners and the children who are taking part in the INMA Study, and to the midwives, obstetricians and paediatricians for their co-operation and help in recruitment and following up of the cohorts. This study could not have been undertaken without the financial support of the 'Instituto de Salud Carlos III' (G03/176) and 'RCESP' (C03/09). This study has also been supported in part by the 'Fundació "La Caixa"' for the Ribera d'Ebre cohort (97/009-00 and 00/077-00), the 'Fondo de Investigación Sanitaria' for the Valencia cohort (FIS 031615), the Menorca cohort (97/0588 and 00/0021-02), Asturias cohort (PI04-2018) and other PI04-1436, PI041509, PI041705, PI041666, PI041931, PI 04/2646, and the European Union Commission (QLK4-1999-01422) and Junta de Andalucía SAS (202/04) for the Granada cohort, and the Menorca cohort (QLK4-2000-00263). ; Peer reviewed
18 pages, 2 figures, 3 tables.-- PMID: 15913055 [PubMed]. ; [ESP] Cada vez existe mayor evidencia de la influencia de la dieta y de la exposición a dosis bajas de tóxicos durante la etapa prenatal y primera infancia sobre la salud y el bienestar en etapas posteriores de la vida. Siguiendo las recomendaciones de la OMS y de la Unión Europea en el año 2003 se constituyó la Red de Investigación Cooperativa Infancia y Medio Ambiente para estudiar los efectos del medio ambiente y la dieta en el desarrollo fetal e infantil en diversas zonas geográficas en España. La Red integra diversos grupos multidisciplinares de investigación y está constituida por seis cohortes, tres preexistentes y tres de novo, que seguirán de forma prospectiva a 3.600 mujeres embarazadas, desde el inicio del embarazo hasta los 4-6 años del niño. Los objetivos generales de la red son: (1) Describir la exposición individual a tóxicos ambientales durante la gestación y la primera infancia. (2) Evaluar los efectos de la exposición a tóxicos y de la dieta en el desarrollo fetal e infantil. (3) Evaluar la interacción entre factores tóxicos, nutricionales y genéticos en el desarrollo fetal e infantil. El seguimiento se realiza en cada trimestre de la gestación, al nacimiento, al año y hasta los cuatro o seis años del niño. La información se recoge mediante cuestionarios, datos clínicos, exploración física, ecografías, biomarcadores y mediciones ambientales. En este trabajo se presentan las características generales de la red y se describe la situación actual de cada una de las cohortes. ; [ENG] Increasingly greater evidence exists as to the influence which diet and exposure to low doses of toxic substances during the prenatal stage and early childhood has on health and well-being throughout later stages of life. Following the WHO and European Union recommendations in 2003, the Cooperative Environment and Childhood Research Network was set up to study the effects of the environment and diet on fetal and early childhood development in different geographical areas of Spain. This Network integrates different multidisciplinary research groups and is comprised of six cohorts - three pre-existing and three de novo - which will follow up prospectively 3,600 pregnant women, from the start of pregnancy up to age 4-6 years of the child. This network's general objectives are: (1) To describe individual exposure to toxic substances in the environment during gestation and early childhood. (2) To evaluate the effects of exposure to toxic substances and diet on fetal and early childhood development. (3) To evaluate the interaction among toxic, nutritional and genetic factors in fetal and early childhood development. The follow-up is done every three months during gestation, at birth, at age one and up to age four or six. The information is gathered by means of questionnaires, clinical data, physical examinations, echographs, biomarkers and environmental measurements. The general characteristics of the network and a description of the current situation of each one of the cohorts are provided in this study. ; La Red no se hubiera podido poner en marcha sin el apoyo económico del Instituto de Salud Carlos III (G03/176). El Estudio INMA ha recibido también ayudas de «Fundació La Caixa» para la cohorte de Ribera d'Ebre (97/009-00 and 00/077-00); de la Comisión de la Unión Europea (QLK4-1999-01422) para la cohorte de Granada; del «Fondo de Investigación Sanitaria» (FIS 031615), del Ministerio de Ciencia y Tecnología (SAF 2002-03508), de la Generalitat Valenciana, Conselleria d'Empresa, Universitat i Ciencia (g03/136) para la cohorte de Valencia; del «Fondo de Investigación Sanitaria» (97/0588 y 00/0021-02) y de la Comisión de la Unión Europea (QLK4-2000-00263) para la cohorte de Menorca. ; Peer reviewed
[ES] Cada vez existe mayor evidencia de la influencia de la dieta y dela exposición a dosis bajas de tóxicos durante la etapa prenatal y primera infancia sobre la salud y el bienestar en etapas posteriores de lavida. Siguiendo las recomendaciones de la OMS y de la Unión Europea en el año 2003 se constituyó la Red de Investigación Cooperativa Infancia y Medio Ambiente para estudiar los efectos del medioambiente y la dieta en el desarrollo fetal e infantil en diversas zonas geográficas en España. La Red integra diversos grupos multidisciplinares de investigación y está constituida por seis cohortes, tres preexistentes y tres de novo, que seguirán de forma prospectiva a 3.600 mujeres embarazadas, desde el inicio del embarazo hasta los 46 años del niño. Los objetivos generales de la red son: (1) Describir la exposición individual a tóxicos ambientales durante la gestación y la primera infancia. (2) Evaluar los efectos de la exposición a tóxicos y de la dieta en el desarrollo fetal e infantil. (3) Evaluar la interacción entre factores tóxicos, nutricionales y genéticos en el desarrollo fetal e infantil. El seguimiento se realiza en cada trimestre de la gestación,al nacimiento, al año y hasta los cuatro o seis años del niño. La información se recoge mediante cuestionarios, datos clínicos, exploración física, ecografías, biomarcadores y mediciones ambientales. En este trabajo se presentan las caracterÌsticas generales de la red y se describe la situación actual de cada una de las cohortes. [EN] Increasingly greater evidence exists as to the influence which diet and exposure to low doses of toxic substances during the prenatal stage and early childhood has on health and well-being throughout later stages of life. Following the WHO and European Union recommendations in 2003, the Cooperative Environment and Childhood Research Network was set up to study the effects of the environment and diet on fetal and early childhood development in different geographical areas of Spain. This Network integrates different multidisciplinary research groups and is comprised of six cohorts--three pre-existing and three de novo--which will follow up prospectively 3,600 pregnant women, from the start of pregnancy up to age 4-6 years of the child. This network's general objectives are: (1) To describe individual exposure to toxic substances in the environment during gestation and early childhood. (2) To evaluate the effects of exposure to toxic substances and diet on fetal and early childhood development. (3) To evaluate the interaction among toxic, nutritional and genetic factors in fetal and early childhood development. The follow-up is done every three months during gestation, at birth, at age one and up to age four or six. The information is gathered by means of questionnaires, clinical data, physical examinations, echographs, biomarkers and environmental measurements. The general characteristics of the network and a description of the current situation of each one of the cohorts are provided in this study. ; Sí
BackgroundMaternal pre-pregnancy obesity may impair infant neuropsychological development, but it is unclear whether intrauterine or confounding factors drive this association.MethodsWe assessed whether maternal pre-pregnancy obesity was associated with neuropsychological development in 1,827 Spanish children. At 5 years, cognitive and psychomotor development was assessed using McCarthy Scales of Children's Abilities, attention deficit hyperactivity disorder (ADHD) symptoms using the Criteria of Diagnostic and Statistical Manual of Mental Disorders, and autism spectrum disorder symptoms using the Childhood Asperger Syndrome Test. Models were adjusted for sociodemographic factors and maternal intelligence quotient. We used paternal obesity as negative control exposure as it involves the same source of confounding than maternal obesity.ResultsThe percentage of obese mothers and fathers was 8% and 12%, respectively. In unadjusted models, children of obese mothers had lower scores than children of normal weight mothers in all McCarthy subscales. After adjustment, only the verbal subscale remained statistically significantly reduced (β: -2.8; 95% confidence interval: -5.3, -0.2). No associations were observed among obese fathers. Maternal and paternal obesity were associated with an increase in ADHD-related symptoms. Parental obesity was not associated with autism symptoms.ConclusionMaternal pre-pregnancy obesity was associated with a reduction in offspring verbal scores at pre-school age. ; This study was funded by grants from European Union (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1)
Objectives: We examined the use of low (<400 μg/day, including no use) and high folic acid supplement (FAS) dosages (≥1000 μg/day) among pregnant women in Spain, and explored factors associated with the use of these non-recommended dosages. Design: Population-based cohort study. Setting Spain. Participants We analysed data from 2332 pregnant women of the INMA study, a prospective mother-child cohort study in Spain. Main outcome measures We assessed usual dietary folate and the use of FAS from preconception to the 3rd month (first period) and from the 4th to the 7th month (second period), using a validated food frequency questionnaire. We used multinomial logistic regression to estimate relative risk ratios (RRRs). Results Over a half of the women used low dosages of FAS in the first and second period while 29% and 17% took high dosages of FAS, respectively. In the first period, tobacco smoking (RRR=1.63), alcohol intake (RRR=1.40), multiparous (RRR=1.44), unplanned pregnancy (RRR=4.20) and previous spontaneous abortion (RRR=0.58, lower use of high FAS dosages among those with previous abortions) were significantly associated with low FAS dosages. Alcohol consumption (RRR=1.42), unplanned pregnancy (RRR=2.66) and previous spontaneous abortion (RRR=0.68) were associated with high dosage use. In the second period, only tobacco smoking was significantly associated with high FAS dosage use (RRR=0.67). Conclusions A high proportion of pregnant women did not reach the recommended dosages of FAS in periconception and a considerable proportion also used FAS dosages ≥1000 μg/day. Action should be planned by the Health Care System and health professionals to improve the appropriate periconceptional use of FAS, taking into consideration the associated factors. ; This study was funded by grants from Instituto de Salud Carlos III and Spanish Ministry of Health (Red INMA G03/176; CB06/02/0041; FIS 97/0588; 00/0021–2, PI061756; PS0901958; FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314; 09/02647; FIS-PI041436, FIS-PI081151, FIS-PI06/0867; FIS-PS09/00090, FIS-PI042018, FIS-PI09 02311, FIS PI11/01007, FISPI13/02429) Universidad de Oviedo, Conselleria de Sanitat Generalitat Valenciana, Generalitat de Catalunya-CIRIT 1999SGR 00241, Department of Health of the Basque Government (2005111093 and 2009111069) and the Provincial Government of Guipuzcoa (DFG06/004 and DFG08/001).
Context: Low maternal free T4 (FT4) has been associated with poor child neurodevelopment in some single-center studies. Evidence remains scarce for the potential adverse effects of high FT4 and whether associations differ in countries with different iodine status. Objective: To assess the association of maternal thyroid function in early pregnancy with child neurodevelopment in countries with a different iodine status. Design, Setting, and Participants: Meta-analysis of individual participant data from 9036 mother–child pairs from three prospective population-based birth cohorts: INMA [Infancia y Medio Ambiente (Environment and Childhood project) (Spain)], Generation R (Netherlands), and ALSPAC (Avon Longitudinal Study of Parents and Children, United Kingdom). The exclusion criteria were multiple pregnancies, fertility treatments, thyroid-interfering medication usage, and known thyroid disease. Main Outcomes: Child nonverbal IQ at 5 to 8 years of age, verbal IQ at 1.5 to 8 years of age, and autistic traits within the clinical range at 5 to 8 years of age. Results: FT4 97.5th percentile was associated with a 1.9-fold (95% CI, 1.0 to 3.4) greater risk of autistic traits. No independent associations were found with TSH. Conclusions: Low maternal FT4 was consistently associated with a lower IQ across the cohorts. Further studies are needed to replicate the findings of autistic traits and investigate the potential modifying role of maternal iodine status. FT4 seems a reliable marker of fetal thyroid state in early pregnancy, regardless of the type of immunoassay. ; EUthyroid Project: European Union's Horizon 2020 research and innovation programme (grant 634453). INMA, Spain: This study was funded by grants from the European Union (grants FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1) and Spain: Instituto de Salud Carlos III (grants Red INMA G03/176, CB06/02/0041, FIS-FEDER: PI041436, PI05/1079, PI06/0867, PI081151, FIS- and PS09/00090, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, and PI16/1288, Miguel Servet-FEDER CP11/00178, CP15/00025, and CPII16/00051, MS13/00054), Generalitat Valenciana: FISABIO (grants UGP 15-230, UGP-15-244, and UGP-15-249), Generalitat de Catalunya-CIRIT 1999SGR 00241, Fundació La Marató de TV3 (grants 090430), Department of Health of the Basque Government (grants 2005111093 and 2009111069), and the Provincial Government of Gipuzkoa (grants DFG06/004 and DFG08/001).
Background A healthy start to life is a major priority in efforts to reduce health inequalities across Europe, with important implications for the health of future generations. There is limited combined evidence on inequalities in health among newborns across a range of European countries. Methods Prospective cohort data of 75 296 newborns from 12 European countries were used. Maternal education, preterm and small for gestational age births were determined at baseline along with covariate data. Regression models were estimated within each cohort and meta-analyses were conducted to compare and measure heterogeneity between cohorts. Results Mother's education was linked to an appreciable risk of preterm and small for gestational age (SGA) births across 12 European countries. The excess risk of preterm births associated with low maternal education was 1.48 (1.29 to 1.69) and 1.84 (0.99 to 2.69) in relative and absolute terms (Relative/Slope Index of Inequality, RII/SII) for all cohorts combined. Similar effects were found for SGA births, but absolute inequalities were greater, with an SII score of 3.64 (1.74 to 5.54). Inequalities at birth were strong in the Netherlands, the UK, Sweden and Spain and marginal in other countries studied. Conclusions This study highlights the value of comparative cohort analysis to better understand the relationship between maternal education and markers of fetal growth in different settings across Europe. ; All phases of this study were supported by a European Union's Seventh Framework Programme grant, 278350, as part of The Determinants to Reduce Health Inequity Via Early Childhood, Realising Fair Employment, and Social Protection (DRIVERS) research programme. The Czech ELSPAC Study was supported by the Ministry of Education of the Czech Republic (LM2011028, LO1214) and the Grant Agency of the Masaryk University (MUNI/M/1075/2013). The Northern Finland Birth Cohort (NFBC8586) received financial support from the Academy of Finland, Biocenter, University of Oulu, Finland, the European Commission (EURO-BLCS, Framework 5 award QLG1-CT-2000-01643), EU FP7 EurHEALTHAgeing -277849, the Medical Research Council, UK ( PrevMetSyn/SALVE) and the MRC Centenary Early Career Award.
Background: Prenatal exposure to air pollutants has been suggested as a possible etiologic factor for the occurrence of autism spectrum disorder. Objectives: We aimed to assess whether prenatal air pollution exposure is associated with childhood autistic traits in the general population. Methods: Ours was a collaborative study of four European population-based birth/child cohorts—CATSS (Sweden), Generation R (the Netherlands), GASPII (Italy), and INMA (Spain). Nitrogen oxides (NO2, NOx) and particulate matter (PM) with diameters of ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and between 2.5 and 10 μm (PMcoarse), and PM2.5 absorbance were estimated for birth addresses by land-use regression models based on monitoring campaigns performed between 2008 and 2011. Levels were extrapolated back in time to exact pregnancy periods. We quantitatively assessed autistic traits when the child was between 4 and 10 years of age. Children were classified with autistic traits within the borderline/clinical range and within the clinical range using validated cut-offs. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. Results: A total of 8,079 children were included. Prenatal air pollution exposure was not associated with autistic traits within the borderline/clinical range (odds ratio = 0.94; 95% CI: 0.81, 1.10 per each 10-μg/m3 increase in NO2 pregnancy levels). Similar results were observed in the different cohorts, for the other pollutants, and in assessments of children with autistic traits within the clinical range or children with autistic traits as a quantitative score. Conclusions: Prenatal exposure to NO2 and PM was not associated with autistic traits in children from 4 to 10 years of age in four European population-based birth/child cohort studies. ; Funding was provided as follows: ESCAPE Project— European Community's Seventh Framework Program (FP7/2007-2011-GA#211250). CATSS, Sweden— Swedish Research Council for Health, Working Life and Welfare (FORTE), Swedish Research Council (VR) Formas, in partner hip with FORTE and VINNOVA (cross-disciplinary research program concerning children's and young people's mental health); VR through the Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) framework grant 340-2013-5867; HKH Kronprinsessan Lovisas förening för barnasjukvård; and the Strategic Research Program in Epidemiology at Karolinska Institutet. Generation R, the Netherlands—The Generation R Study is conducted by the Erasmus University Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University Rotterdam; the Municipal Health Service Rotterdam area, Rotterdam; the Rotterdam Homecare foundation, Rotterdam; and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR-MDC), Rotterdam. The general design of the Generation R Study is made possible by financial support from the Erasmus University Medical Center, Rotterdam; the Erasmus University Rotterdam; the Netherlands Organization for Health Research and Development (ZonMw); the Netherlands Organization for Scientific Research (NWO); and the Ministry of Health, Welfare and Sport. The Netherlands Organisation for Applied Scientific Research (TNO) received funding from the Netherlands Ministry of Infrastructure and the Environment to support exposure assessment. GASPII, Italy—grant from the Italian Ministry of Health (ex art.12, 2001). INMA, Spain— grants from Instituto de Salud Carlos III (Red INMA G03/176 and CB06/02/0041 FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314, 09/02647, 11/01007, 11/02591, CP11/00178, FIS-PI041436, FIS-PI081151, FIS-PI06/0867, FIS-PS09/00090), PI13/1944, PI13_02032, PI14/0891, PI14/1687, MS13/00054, UE (FP7-ENV-2011 cod 282957, and HEALTH.2010.2.4.5-1); Generalitat de Catalunya-CIRIT 1999SGR 00241; La Fundació La Marató de TV3 (090430); Conselleria de Sanitat Generalitat Valenciana; Department of Health of the Basque Government (2005111093 and 2009111069); and Provincial Government of Gipuzkoa (DFG06/004 and DFG08/001). V.W.V.J. received an additional grant from the Netherlands Organization for Health Research and Development (ZonMw 90700303, 916.10159). A.G.'s work was supported by a research grant from the European Community's 7th Framework Programme (FP7/2008–2013-GA#212652). A full roster of the INMA project investigators can be found online (http://www. proyectoinma.org/presentacion-inma/listado-investigadores/ en_listado-investigadores.html).