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Does exposure to black carbon during pregnancy increase the risk of autism spectrum disorder? A cohort study from Southern Sweden

Andersson Nystedt, Tanya LU orcid ; Lawlor, Cale LU ; Pira, Kajsa LU orcid ; Malmqvist, Ebba LU orcid ; Lim, Youn Hee ; Zhang, Jiawei ; So, Rina ; Bergmann, Marie ; Jovanovic Andersen, Zorana and Oudin, Anna LU orcid (2025) In Environmental Research 286.
Abstract

Black carbon (BC), a major component of fine particulate matter (PM2.5), has been implicated in adverse neurodevelopmental outcomes, including autism spectrum disorders (ASD). While PM2.5 has been associated with increased ASD risk, the specific role of BC remains uncertain. This study aimed to assess prenatal exposure to BC and risk for ASD development in a low exposure setting, using a large, high-quality register database, with disease diagnosis made by a single team. We used the Maternal Air Pollution in Southern Sweden cohort, encompassing nearly all births in the Malmö region, linked with ASD diagnoses. Exposure estimates included locally emitted PM2.5 and BC, based on residential address during... (More)

Black carbon (BC), a major component of fine particulate matter (PM2.5), has been implicated in adverse neurodevelopmental outcomes, including autism spectrum disorders (ASD). While PM2.5 has been associated with increased ASD risk, the specific role of BC remains uncertain. This study aimed to assess prenatal exposure to BC and risk for ASD development in a low exposure setting, using a large, high-quality register database, with disease diagnosis made by a single team. We used the Maternal Air Pollution in Southern Sweden cohort, encompassing nearly all births in the Malmö region, linked with ASD diagnoses. Exposure estimates included locally emitted PM2.5 and BC, based on residential address during the entire pregnancy and for each trimester separately. Odds ratios were estimated with logistic regression models, adjusted for potential confounders. The final analytical cohort included 40,156 individuals. Associations between prenatal exposure to BC and ASD were observed in multiple models and across different trimesters, with an adjusted odds ratio (OR) of 1.17 (95 % CI: 0.97–1.41) per intra-quartile range (IQR) increase in BC exposure over the full pregnancy. For non-BC PM2.5, the OR was 1.22 (95 % CI: 1.00–1.49) per IQR increase. This study utilised a large, high-quality register of births, matched to residential addresses and demographics factors, with a highly reliable disease outcome, against high-quality air pollution models. Positive trends were seen between BC exposure and ASD outcome, which were attenuated slightly, and becoming non-significant, when controlling for covariates. We observed stronger associations for PM2.5 than BC. This study is novel in the precision of individual data, exposure and diagnosis, and is useful for future meta-analyses.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Air pollution, Autism, Black carbon, PM, Prenatal exposure
in
Environmental Research
volume
286
article number
122700
publisher
Elsevier
external identifiers
  • scopus:105014819285
  • pmid:40902775
ISSN
0013-9351
DOI
10.1016/j.envres.2025.122700
language
English
LU publication?
yes
id
5920681a-e528-4f6a-be55-3c0ed8547a61
date added to LUP
2025-10-02 16:07:36
date last changed
2025-10-16 18:01:55
@article{5920681a-e528-4f6a-be55-3c0ed8547a61,
  abstract     = {{<p>Black carbon (BC), a major component of fine particulate matter (PM<sub>2.5</sub>), has been implicated in adverse neurodevelopmental outcomes, including autism spectrum disorders (ASD). While PM<sub>2.5</sub> has been associated with increased ASD risk, the specific role of BC remains uncertain. This study aimed to assess prenatal exposure to BC and risk for ASD development in a low exposure setting, using a large, high-quality register database, with disease diagnosis made by a single team. We used the Maternal Air Pollution in Southern Sweden cohort, encompassing nearly all births in the Malmö region, linked with ASD diagnoses. Exposure estimates included locally emitted PM<sub>2.5</sub> and BC, based on residential address during the entire pregnancy and for each trimester separately. Odds ratios were estimated with logistic regression models, adjusted for potential confounders. The final analytical cohort included 40,156 individuals. Associations between prenatal exposure to BC and ASD were observed in multiple models and across different trimesters, with an adjusted odds ratio (OR) of 1.17 (95 % CI: 0.97–1.41) per intra-quartile range (IQR) increase in BC exposure over the full pregnancy. For non-BC PM<sub>2.5</sub>, the OR was 1.22 (95 % CI: 1.00–1.49) per IQR increase. This study utilised a large, high-quality register of births, matched to residential addresses and demographics factors, with a highly reliable disease outcome, against high-quality air pollution models. Positive trends were seen between BC exposure and ASD outcome, which were attenuated slightly, and becoming non-significant, when controlling for covariates. We observed stronger associations for PM<sub>2.5</sub> than BC. This study is novel in the precision of individual data, exposure and diagnosis, and is useful for future meta-analyses.</p>}},
  author       = {{Andersson Nystedt, Tanya and Lawlor, Cale and Pira, Kajsa and Malmqvist, Ebba and Lim, Youn Hee and Zhang, Jiawei and So, Rina and Bergmann, Marie and Jovanovic Andersen, Zorana and Oudin, Anna}},
  issn         = {{0013-9351}},
  keywords     = {{Air pollution; Autism; Black carbon; PM; Prenatal exposure}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Environmental Research}},
  title        = {{Does exposure to black carbon during pregnancy increase the risk of autism spectrum disorder? A cohort study from Southern Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.envres.2025.122700}},
  doi          = {{10.1016/j.envres.2025.122700}},
  volume       = {{286}},
  year         = {{2025}},
}