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      Outdoor Air Pollution, Preterm Birth, and Low Birth Weight: Analysis of the World Health Organization Global Survey on Maternal and Perinatal Health

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          Abstract

          Background: Inhaling fine particles (particulate matter with diameter ≤ 2.5 μm; PM 2.5) can induce oxidative stress and inflammation, and may contribute to onset of preterm labor and other adverse perinatal outcomes.

          Objectives: We examined whether outdoor PM 2.5 was associated with adverse birth outcomes among 22 countries in the World Health Organization Global Survey on Maternal and Perinatal Health from 2004 through 2008.

          Methods: Long-term average (2001–2006) estimates of outdoor PM 2.5 were assigned to 50-km–radius circular buffers around each health clinic where births occurred. We used generalized estimating equations to determine associations between clinic-level PM 2.5 levels and preterm birth and low birth weight at the individual level, adjusting for seasonality and potential confounders at individual, clinic, and country levels. Country-specific associations were also investigated.

          Results: Across all countries, adjusting for seasonality, PM 2.5 was not associated with preterm birth, but was associated with low birth weight [odds ratio (OR) = 1.22; 95% CI: 1.07, 1.39 for fourth quartile of PM 2.5 (> 20.2 μg/m 3) compared with the first quartile (< 6.3 μg/m 3)]. In China, the country with the largest PM 2.5 range, preterm birth and low birth weight both were associated with the highest quartile of PM 2.5 only, which suggests a possible threshold effect (OR = 2.54; CI: 1.42, 4.55 and OR = 1.99; CI: 1.06, 3.72 for preterm birth and low birth weight, respectively, for PM 2.5 ≥ 36.5 μg/m 3 compared with PM 2.5 < 12.5 μg/m 3).

          Conclusions: Outdoor PM 2.5 concentrations were associated with low birth weight but not preterm birth. In rapidly developing countries, such as China, the highest levels of air pollution may be of concern for both outcomes.

          Citation: Fleischer NL, Merialdi M, van Donkelaar A, Vadillo-Ortega F, Martin RV, Betran AP, Souza JP, O´Neill MS. 2014. Outdoor air pollution, preterm birth, and low birth weight: analysis of the World Health Organization Global Survey on Maternal and Perinatal Health. Environ Health Perspect 122:425–430;  http://dx.doi.org/10.1289/ehp.1306837

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          Second-generation operational algorithm: Retrieval of aerosol properties over land from inversion of Moderate Resolution Imaging Spectroradiometer spectral reflectance

          Robert C Levy, Lorraine Remer, Shana Mattoo … (2007)
          Article 0 comments Cited 221 times – based on 0 reviews     Review now
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            Ambient Air Pollution and Pregnancy Outcomes: A Review of the Literature

            Radim J. Sram, Blanka Binkova, Jan Dejmek (posthumous) … (2005)
            Over the last decade or so, a large number of studies have investigated the possible adverse effects of ambient air pollution on birth outcomes. We reviewed these studies, which were identified by a systematic search of the main scientific databases. Virtually all reviewed studies were population based, with information on exposure to air pollution derived from routine monitoring sources. Overall, there is evidence implicating air pollution in adverse effects on different birth outcomes, but the strength of the evidence differs between outcomes. The evidence is sufficient to infer a causal relationship between particulate air pollution and respiratory deaths in the postneonatal period. For air pollution and birth weight the evidence suggests causality, but further studies are needed to confirm an effect and its size and to clarify the most vulnerable period of pregnancy and the role of different pollutants. For preterm births and intrauterine growth retardation (IUGR) the evidence as yet is insufficient to infer causality, but the available evidence justifies further studies. Molecular epidemiologic studies suggest possible biologic mechanisms for the effect on birth weight, premature birth, and IUGR and support the view that the relation between pollution and these birth outcomes is genuine. For birth defects, the evidence base so far is insufficient to draw conclusions. In terms of exposure to specific pollutants, particulates seem the most important for infant deaths, and the effect on IUGR seems linked to polycyclic aromatic hydrocarbons, but the existing evidence does not allow precise identification of the different pollutants or the timing of exposure that can result in adverse pregnancy outcomes.
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              A Cohort Study of Traffic-Related Air Pollution Impacts on Birth Outcomes

              Michael Brauer, Cornel Lencar, Lillian Tamburic … (2008)
              Background Evidence suggests that air pollution exposure adversely affects pregnancy outcomes. Few studies have examined individual-level intraurban exposure contrasts. Objectives We evaluated the impacts of air pollution on small for gestational age (SGA) birth weight, low full-term birth weight (LBW), and preterm birth using spatiotemporal exposure metrics. Methods With linked administrative data, we identified 70,249 singleton births (1999–2002) with complete covariate data (sex, ethnicity, parity, birth month and year, income, education) and maternal residential history in Vancouver, British Columbia, Canada. We estimated residential exposures by month of pregnancy using nearest and inverse-distance weighting (IDW) of study area monitors [carbon monoxide, nitrogen dioxide, nitric oxide, ozone, sulfur dioxide, and particulate matter < 2.5 (PM2.5) or < 10 (PM10) μm in aerodynamic diameter], temporally adjusted land use regression (LUR) models (NO, NO2, PM2.5, black carbon), and proximity to major roads. Using logistic regression, we estimated the risk of mean (entire pregnancy, first and last month of pregnancy, first and last 3 months) air pollution concentrations on SGA (< 10th percentile), term LBW (< 2,500 g), and preterm birth. Results Residence within 50 m of highways was associated with a 26% increase in SGA [95% confidence interval (CI), 1.07–1.49] and an 11% (95% CI, 1.01–1.23) increase in LBW. Exposure to all air pollutants except O3 was associated with SGA, with similar odds ratios (ORs) for LUR and monitoring estimates (e.g., LUR: OR = 1.02; 95% CI, 1.00–1.04; IDW: OR = 1.05; 95% CI, 1.03–1.08 per 10-μg/m3 increase in NO). For preterm births, associations were observed with PM2.5 for births < 37 weeks gestation (and for other pollutants at < 30 weeks). No consistent patterns suggested exposure windows of greater relevance. Conclusion Associations between traffic-related air pollution and birth outcomes were observed in a population-based cohort with relatively low ambient air pollution exposure.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Environ Health Perspect
                Journal ID (iso-abbrev): Environ. Health Perspect
                Journal ID (publisher-id): EHP
                Title: Environmental Health Perspectives
                Publisher: National Institute of Environmental Health Sciences
                ISSN (Print): 0091-6765
                ISSN (Electronic): 1552-9924
                Publication date (Electronic): 07 February 2014
                Publication date (Print): April 2014
                Volume: 122
                Issue: 4
                Pages: 425-430
                Affiliations
                [1 ]University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA
                [2 ]Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
                [3 ]Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
                [4 ]School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
                [5 ]Instituto Nacional de Medicina Genomica, Mexico City, Mexico
                [6 ]Harvard-Smithsonian Center for Astrophysics, Cambridge, Massachusetts, USA
                [7 ]University of Michigan School of Public Health, Ann Arbor, Michigan, USA
                Author notes
                Address correspondence to N.L. Fleischer, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St., 4th Floor, Columbia, SC 29208 USA. Telephone: (803) 777-6220. E-mail: nfleischer@ 123456sc.edu
                Article
                Publisher ID: ehp.1306837
                DOI: 10.1289/ehp.1306837
                PMC ID: 3984219
                PubMed ID: 24508912
                SO-VID: ce7215b5-7369-4282-a8f9-ecd379ed9af7
                License:

                Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, “Reproduced with permission from Environmental Health Perspectives”); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright.

                History
                Date received : 22 March 2013
                Date accepted : 04 February 2014
                Date: 07 February 2014
                Date: 01 April 2014
                Categories
                Subject: Children's Health

                ScienceOpen disciplines: Public health
                Data availability:
                ScienceOpen disciplines: Public health

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