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Prenatal exposure to air pollutants including particulate matter (<2.5 μm of diameter,PM 2.5)and nitrogen dioxide (NO 2) has been identified as a potential risk factor for neuropsychological developmental and mental health disorders. This study aimed to analyze the associations between prenatal PM 2.5 and NO 2 exposure and cognitive functions in children at 4–6 years of age, including sex differences, and the modification effect of the duration predominant breastfeeding these associations. This study was conducted as part of the INMA project, a population-based birth cohort study in Spain (n = 1119). Each of the pregnant mothers was assigned a prenatal exposure to PM 2.5 and NO 2 for their whole pregnancy based on their place of residence. At the 4-6 year-old follow-up, infants' neuropsychological development was assessed using McCarthy scales: Verbal, Perceptive-Manipulative, Numeric, General Cognitive, Memory and Motor (gross and fine). Between 6 and 14 months of age, information concerning breastfeeding was gathered with a questionnaire. Regression analyses were performed to estimate the associations between exposure and outcomes, accounting for potential confounders. The analyses were stratified by child sex and breastfeeding duration. The majority of coefficients for the different cognitive domains were negative either for PM 2.5 and NO 2 , though none was statistically significant. After stratifying by sex, the associations become even more negative for boys, with some of the associations becoming statistically significant (memory both for PM 2.5 and NO 2), and global cognition and verbal for NO 2. Duration of predominant breastfeeding was not found to have a modifying effect. These findings suggest a sex-dependent effects on neuropsychological development at 4–6 years of age, with a greater vulnerability in boys, specifically in domains related to memory, verbal and general cognition. No modifying effect was observed for duration of predominant breastfeeding. • Air pollution exposure in pregnancy shows sex-dependent neuropsychological effects. • Boys show a greater vulnerability in cognitive functions. • Duration of breastfeeding did not modify the effect of air pollutants. [ABSTRACT FROM AUTHOR]

Background Urban residents may experience cognitive fatigue and little opportunity for mental restoration due to a lack of access to nature. Natural outdoor environments (NOE) are thought to be beneficial for cognitive functioning, but underlying mechanisms are not clear. Objectives To investigate the long-term association between NOE and cognitive function, and its potential mediators. Methods This cross-sectional study was based on adult participants of the Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions in Europe (PHENOTYPE) project. Data were collected in Barcelona, Spain; Doetinchem, the Netherlands; and Stoke-on-Trent, United Kingdom. We assessed residential distance to NOE, residential surrounding greenness, perceived amount of neighborhood NOE, and engagement with NOE. Cognitive function was assessed with the Color Trails Test (CTT). Mediation analysis was undertaken following Baron and Kenny. Results Each 100 m increase in residential distance to NOE was associated with a longer CTT completion time of 1.50% (95% CI 0.13, 2.89). No associations were found for other NOE indicators and cognitive function. Neighborhood social cohesion was (marginally) significantly associated with both residential distance to NOE and CTT completion time, but no evidence for mediation was found. Nor were there indications for mediation by physical activity, social interaction with neighbors, loneliness, mental health, air pollution worries, or noise annoyance. Conclusions Our findings provide some indication that proximity to nature may benefit cognitive function. We could not establish which mechanisms may explain this relationship. [ABSTRACT FROM AUTHOR]