Heterogeneous Distributed Lag Models to Estimate Personalized Effects of Maternal Exposures to Air Pollution

Children's health studies support an association between maternal environmental exposures and children's birth and health outcomes. A common goal in such studies is to identify critical windows of susceptibility -- periods during gestation with increased association between maternal exposures and a future outcome. The associations and timings of critical windows are likely heterogeneous across different levels of individual, family, and neighborhood characteristics. However, the few studies that have considered effect modification were limited to a few pre-specified subgroups. We propose a statistical learning method to estimate critical windows at the individual level and identify important characteristics that induce heterogeneity. The proposed approach uses distributed lag models (DLMs) modified by Bayesian additive regression trees to account for effect heterogeneity based on a potentially high-dimensional set of modifying factors. We show in a simulation study that our model can identify both critical windows and modifiers responsible for DLM heterogeneity. We estimate the relationship between weekly exposures to fine particulate matter during gestation and birth weight in an administrative Colorado birth cohort. We identify maternal body mass index (BMI), age, Hispanic designation, and education as modifiers of the distributed lag effects and find non-Hispanics with increased BMI to be a susceptible population.