Prospective Association of Air-Purifier Usage during Pregnancy with Infant Neurodevelopment: A Nationwide Longitudinal Study-Japan Environment and Children's Study (JECS)

Fetal exposure to particulate matter (PM) is associated with infant developmental delay likely via neuroinflammation and prefrontal cortex lesions; however, whether air-purifier usage, which can reduce indoor PM levels, is related to infant developmental delay remains unknown. We therefore examined the prospective relationship between air-purifier usage during pregnancy and infant developmental delay by analyzing 82,441 mother-infant pairs using a simple yes/no questionnaire. Developmental delays at 6 and 12 months were assessed in five areas using the Ages and Stages Questionnaire, Third Edition. A generalized linear mixed model analysis was used to derive adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) while controlling for 20 covariates. The analysis revealed that air-purifier usage was associated with developmental delays in fine motor (AOR: 0.91, 95% CI: 0.83-0.99) and problem solving (AOR: 0.83, 95% CI: 0.77-0.90) at 6 months and in communication (AOR: 0.86, 95% CI: 0.79-0.93), fine motor (AOR: 0.87, 95% CI: 0.82-0.92), problem solving (AOR: 0.83, 95% CI: 0.77-0.88), and personal-social (AOR: 0.79, 95% CI: 0.72-0.86) at 12 months. In conclusion, a negative association exists between air-purifier usage during pregnancy and infant neurodevelopmental delay that strengthens with time. Our results outline the potential role of air purifiers in inhibiting infant neurodevelopmental delay.