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Sally Ann Lederman,¹ Virginia Rauh,¹ Lisa Weiss,¹ Janet L. Stein,² Lori A. Hoepner,¹ Mark Becker,³ and Frederica P. Perera¹

¹Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York, USA; ²Department of Obstetrics and Gynecology, Beth Israel Medical Center, New York, New York, USA; ³Center for International Earth Science Information Network, Columbia University, New York, New York, USA

Abstract
The effects of prenatal exposure to pollutants from the World Trade Center (WTC) disaster on fetal growth and subsequent health and development of exposed children remain a source of concern. We assessed the impact of gestational timing of the disaster and distance from the WTC in the 4 weeks after 11 September on the birth outcomes of 300 nonsmoking women who were pregnant at the time of the event. They were recruited at delivery between December 2001 and June 2002 from three hospitals close to the WTC site. Residential and work addresses of all participants for each of the 4 weeks after 11 September 2001 were geocoded for classification by place and timing of exposure. Average daily hours spent at each location were based on the women's reports for each week. Biomedical pregnancy and delivery data extracted from the medical records of each mother and newborn included medical complications, type of delivery, length of gestation, birth weight, birth length, and head circumference. Term infants born to women who were pregnant on 11 September 2001 and who were living within a 2-mile radius of the WTC during the month after the event showed significant decrements in term birth weight (-149 g) and birth length (-0.82 cm) , compared with infants born to the other pregnant women studied, after controlling for sociodemographic and biomedical risk factors. The decrements remained significant with adjustment for gestational duration (-122 g and -0.74 cm, respectively) . Women in the first trimester of pregnancy at the time of the WTC event delivered infants with significantly shorter gestation (-3.6 days) and a smaller head circumference (-0.48 cm) , compared with women at later stages of pregnancy, regardless of the distance of their residence or work sites from the WTC. The observed adverse effects suggest an impact of pollutants and/or stress related to the WTC disaster and have implications for the health and development of exposed children. Key words: birth length, birth weight, geographic information systems, gestational duration, head circumference, newborns, World Trade Center. Environ Health Perspect 112: 1772-1778 (2004) . doi:10.1289/ehp.7348 available via http://dx.doi.org/ [Online 8 September 2004]

Address correspondence to S.A. Lederman, Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 100 Haven Ave., #25F, Tower 3, New York, NY 10032 USA. Telephone: (212) 304-7280. Fax: (212) 544-1943. E-mail: sal1@columbia.edu

We thank J.C. King, G. DelPriore, the staff of the Elizabeth Seton Childbearing Center ; and the staff of the obstetrics and pediatric departments and the administrations of the three recruitment hospitals, who made this study possible on very short notice ; K. Lester for her role in implementing and coordinating the fieldwork ; R. Day, C. Fields, M. Horton, S.B. Joy, K. Wan, E. Wong, and A. Sanchez, who assisted her in enrolling participants ; H. Andrews for statistical advice ; G. Simpson for assistance with data management ; and K. Sims for office assistance to the project. We express our gratitude to the women who were willing to consider our project while they were in labor and to participate at a difficult and busy time.

This work was supported by grants from the September 11th Fund of the New York Community Trust and United Way of New York City ; by the New York Times 9/11 Neediest Fund ; by a special supplemental grant, National Institute of Environmental Health Sciences (NIEHS) ES09089, awarded to the NIEHS Center for Environmental Health in northern Manhattan ; and by NIEHS grants 5P01 ES09600 and 5RO1 ES08977, and U.S. Environmental Protection Agency R827027, awarded to the Columbia Center for Children's Environmental Health. The funders listed had no role in the design and conduct of the study ; in the collection, analysis, or interpretation of the data ; or in reviewing or approving the manuscript.

The authors declare they have no competing financial interests.

Received 28 June 2004 ; accepted 7 September 2004.