D26-17 Prenatal Air Pollution Exposure and Risk of Early Childhood Pneumonia in Jakarta, a Developing Country Megacity

Rationales

Air pollution is a major public health problem, but studies on its effects on children’s respiratory systems in developing countries remain limited. We conducted a retrospective cohort study of children under 5 years of age in the Special Capital Region of Jakarta, Indonesia, from 2015 to 2024 to examine the association between prenatal air pollution exposure and early childhood pneumonia. Jakarta has been ranked among the world’s 10 most polluted cities in recent years.

Methods

A total of 3790 mother-child dyads were identified from the Indonesian national health insurance longitudinal data and included in this study. Pneumonia cases are based on ICD-10 codes reported by the referral hospital, J09-18. Air pollution data were collected from the Environmental Agency of Jakarta Province. Exposure was defined as the average daily concentration of PM2.5, NO2, O3, and SO2 at the mother’s residential address during a 40-week exposure window preceding childbirth. Associations were estimated using multivariable logistic regression models. Covariates considered in this study included the infant’s gender, presence of respiratory distress or complications during the newborn period, domicile, maternal age, and maternal asthma history. Stratified analyses were used to identify key subpopulations.

Results

During the 10-year study period, 390 (10.3%) incident cases of pneumonia were identified. We observed significant associations between prenatal exposure to air pollutants, specifically PM2.5 and SO2, and the incidence of pneumonia in young children. For every 10 μg/m3 increase, the odds ratios were 1.12 for PM2.5 and 1.11 for SO2 during the whole pregnancy period. Moreover, sex-stratified analysis suggests that boys had a higher sensitivity to PM2.5 exposure. In contrast, we did not observe a similar association between prenatal exposure to NO2 or O3 and the investigated endpoints.

Conclusion

Prenatal exposure to air pollution, particularly PM2.5 and SO2, is associated with elevated susceptibility to pneumonia in early childhood. This study highlights the critical need for comprehensive air quality improvements and targeted public health interventions to protect and strengthen children’s lung health in urban areas of developing countries.

This abstract is funded by: None