Prenatal exposure to environmental air pollution and psychosocial stress jointly contribute to the epigenetic regulation of the serotonin transporter gene in newborns

Mol Psychiatry. 2023 Aug;28(8):3503-3511. doi: 10.1038/s41380-023-02206-9. Epub 2023 Aug 4.


Antenatal exposures to maternal stress and to particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5) have been independently associated with developmental outcomes in early infancy and beyond. Knowledge about their joint impact, biological mechanisms of their effects and timing-effects, is still limited. Both PM2.5 and maternal stress exposure during pregnancy might result in altered patterns of DNA methylation in specific stress-related genes, such as the serotonin transporter gene (SLC6A4 DNAm), that might, in turn, influence infant development across several domains, including bio-behavioral, cognitive and socio-emotional domains. Here, we investigated the independent and interactive influence of variations in antenatal exposures to maternal pandemic-related stress (PRS) and PM2.5 on SLC6A4 DNAm levels in newborns. Mother-infant dyads (N = 307) were enrolled at delivery during the COVID-19 pandemic. Infants' methylation status was assessed in 13 CpG sites within the SLC6A4 gene's region (chr17:28562750-28562958) in buccal cells at birth and women retrospectively report on PRS. PM2.5 exposure throughout the entire gestation and at each gestational trimester was estimated using a spatiotemporal model based on residential address. Among several potentially confounding socio-demographic and health-related factors, infant's sex was significantly associated with infants' SLC6A4 DNAm levels, thus hierarchical regression models were adjusted for infant's sex. Higher levels of SLC6A4 DNAm at 6 CpG sites were found in newborns born to mothers reporting higher levels of antenatal PRS and greater PM2.5 exposure across gestation, while adjusting for infant's sex. These effects were especially evident when exposure to elevated PM2.5 occurred during the second trimester of pregnancy. Several important brain processes (e.g., synaptogenesis and myelination) occur during mid-pregnancy, potentially making the second trimester a sensitive time window for the effects of stress-related exposures. Understanding the interplay between environmental and individual-level stressors has important implications for the improvement of mother-infant health during and after the pandemic.

MeSH terms

  • Air Pollutants* / adverse effects
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • Child
  • Epigenesis, Genetic / genetics
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Maternal Exposure / adverse effects
  • Mouth Mucosa / chemistry
  • Pandemics
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis
  • Pregnancy
  • Prenatal Exposure Delayed Effects* / genetics
  • Retrospective Studies
  • Serotonin Plasma Membrane Transport Proteins / genetics
  • Stress, Psychological / genetics


  • Air Pollutants
  • Serotonin Plasma Membrane Transport Proteins
  • Particulate Matter
  • SLC6A4 protein, human