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Evidence from murine research supports that fine particulate matter (PM 2.5 ) may stimulate the hypothalamic-pituitary-adrenal axis, leading to elevated circulating glucocorticoid levels. Epidemiologic research examining parallel associations document similar associations. We examined these associations among a diverse sample of pregnant individuals exposed to lower levels of ambient PM 2.5 . Participants included pregnant individuals enrolled in the PRogramming of Intergenerational Stress Mechanisms (PRISM) pre-birth cohort. Daily residential PM 2.5  exposure was estimated using a satellite-based spatial-temporal hybrid model. Maternal 3rd trimester salivary cortisol levels were used to calculate several features of the diurnal cortisol rhythm. We used multivariable linear regression to examine PM 2.5  during the pre-conception period and during each trimester in relation to cortisol awakening rise (CAR), slope, and area under the curve relative to ground (AUC G ). The average PM 2.5  exposure level across pregnancy was 8.13 µg/m 3 . PM 2.5  in each exposure period was positively associated with AUC G , a measure of total cortisol output across the day. We also observed an inverse association between PM 2.5  in the 3rd trimester and diurnal slope, indicating a steeper decline in cortisol throughout the day with increasing exposure. We did not detect strong associations between PM 2.5  and slope for the other exposure periods or between PM 2.5  and CAR for any exposure period. In this sample, PM 2.5  exposure across the preconception and pregnancy periods was associated with increased cortisol output, even at levels below the U.S. National Ambient Air Quality Annual Standard for PM 2.5  of 12.0 µg/m 3 .

Ambient PM 2.5 exposure and salivary cortisol output during pregnancy in a multi-ethnic urban sample