When they attended Aberdeen Royal Infirmary on the morning of their medical (non-surgical) termination, women older than 16 years were recruited and full written informed consent was obtained by nurses working independently of the study. In the study, women seeking elective termination of pregnancy (between 7 and 20 weeks of gestation) for non-medical reasons registered at Aberdeen Community Health Care Village were given a SAFeR study patient information sheet to take away with them. The overarching objective of SAFeR is to study the human fetus during a normal pregnancy versus pregnancies with challenging maternal lifestyle (eg, smoking) or environmental (eg, pollution) factors. The SAFeR study is an ongoing study recruiting women across Aberdeen in the Grampian region in Scotland, UK, undergoing non-medical, elective terminations by medical (ie, non-surgical) means. We did appropriate validation experiments of all samples to confirm the carbonaceous nature of the identified particles. We used white light generation under femtosecond pulsed illumination to detect black carbon particles in samples collected at the maternal-fetal interface. From the SAFeR study, we included 36 fetuses of gestational age 7–20 weeks with cotinine concentrations indicative of non-smoking status. From the ENVIRONAGE study, we included 60 randomly selected mother-neonate pairs, excluding all mothers who reported that they ever smoked. In this analysis, we used maternal-perinatal and fetal samples collected within the framework of two independent studies: the ENVIRONAGE (Environmental Influences on Ageing in Early Life) birth cohort of mothers giving birth at the East-Limburg Hospital in Genk, Belgium, and the SAFeR (Scottish Advanced Fetal Research) cohort of terminated, normally progressing pregnancies among women aged 16 years and older in Aberdeen and the Grampian region, UK. The Lancet Regional Health – Western Pacific.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.
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