Acute associations between air pollution on premature rupture of membranes in Hefei, China

Zhang, Chao; Li, Sha; Guo, Gan-Lan; Hao, Jingwen; Cheng, Peng; Xiong, Lilin; Chen, Shu-Ting; Cao, Jiyu; Guo, Yi

doi:10.1007/s10653-021-00833-1

Cited by 12 publications

(9 citation statements)

References 51 publications

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“…These mechanisms can negatively impact transplacental nutrient and oxygen support, leading to altered epigenetic changes, restricted intrauterine growth and eventually preterm birth. Evidence also suggests that air pollution may also trigger preterm premature rupture of membranes (PPROM), which is the leading identifiable cause of preterm delivery 50‐52 . However, since we do not have data on the time of PPROM, we were unable to examine this pathway.…”

Section: Discussionmentioning

confidence: 99%

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Air pollution and preterm birth: A time‐stratified case‐crossover study in the San Joaquin Valley of California

Martinez

Chan‐Golston

2021

Paediatric Perinatal Epid

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Background Air pollution is linked to preterm birth (PTB), but existing studies are primarily focused on chronic exposures, conducted in areas with moderate pollution, and/or subject to confounding. Objectives We investigated short‐term associations between two pollutants [particulate matter <2.5 microns (PM2.5) and ozone] and PTB, and estimated excess PTB cases potentially attributed to these pollutants. Methods This time‐stratified case‐crossover study includes 196,970 singleton pregnancies affected by PTB and early term birth from the San Joaquin Valley (SJV), California, USA (2007–2015). Daily ozone and PM2.5 concentrations were estimated by the SJV Air Pollution Control District and geospatially linked to maternal zip code. We used conditional logistic regression models to estimate the odds ratio (OR) and 95% confidence intervals (CI) for the associations between an interquartile range (IQR) increase in pollutants and very preterm (VPTB, 20–34 weeks), moderate preterm (MPTB, 34–36 weeks) and early term births (ETB, 37–38 weeks). We adjusted all models for co‐pollutants and meteorological factors. Results During warm seasons (May‐October), an IQR increase in ozone was associated with 9–11% increased odds of VPTB from lag 0 (ORlag0 1.09, 95% CI 1.04,1.16) to lag 7 (ORlag7 1.11, 95% CI 1.04,1.16). Findings were consistent for MPTB and ETB. Ozone was potentially responsible for an excess of 3–6 VPTBs, 7–9 PTBs and 24–42 ETBs per 1,000 singleton deliveries. During cold seasons (November‐April), increased PM2.5 exposure was associated with 5–6% increased odds of VPTB beginning at lag 3 (ORlag3 1.06, 95% CI 1.02,1.11). PM2.5 was associated with an excess of 1–3 VPTBs, 0–3 MPTBs and 6–18 ETBs per 1,000 singleton deliveries. Conclusions PM2.5 and ozone are associated with increased risk of VPTB, MPTB and ETB within one week of exposure and are potential contributors to the increasing PTB trend. More research is needed to further understand the role of air pollution on PTB risk.

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Section: Discussionmentioning

confidence: 99%

“…Evidence also suggests that air pollution may also trigger preterm premature rupture of membranes (PPROM), which is the leading identifiable cause of preterm delivery. [50][51][52] However, since we do not have data on the time of PPROM, we were unable to examine this pathway.…”

Section: Discussionmentioning

confidence: 99%

Air pollution and preterm birth: A time‐stratified case‐crossover study in the San Joaquin Valley of California

Martinez

Chan‐Golston

2021

Paediatric Perinatal Epid

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“…The relationship between elevated air pollution and PROM has been examined but with inconsistent results. 35 – 37 Contrasting results presented in these studies may be attributed to apparent differences in levels of air pollution, inconsistent domestic conditions, and differences in population characteristics. A prospective cohort study conducted in Wuhan, China, indicated that

levels during pregnancy increased the risk of PROM, and the estimated

exposure concentration was

during the entire pregnancy, which is similar to the finding in our current study.…”

Section: Discussionmentioning

confidence: 61%

Prenatal Exposure to Air Pollution and Pre-Labor Rupture of Membranes in a Prospective Cohort Study: The Role of Maternal Hemoglobin and Iron Supplementation

Yin

et al. 2023

Environ Health Perspect

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Background: Exposure to air pollution in prenatal period is associated with prelabor rupture of membranes (PROM). However, the sensitive exposure time windows and the possible biological mechanisms underlying this association remain unclear. Objective: We aimed to identify the sensitive time windows of exposure to air pollution for PROM risk. Further, we examined whether maternal hemoglobin levels mediate the association between exposure to air pollution and PROM, as well as investigated the potential effect of iron supplementation on this association. Method: From 2015 to 2021, 6,824 mother–newborn pairs were enrolled in the study from three hospitals in Hefei, China. We obtained air pollutant data [particulate matter (PM) with aerodynamic diameter ( ), PM with aerodynamic diameter ( ), sulfur dioxide ( ), and carbon monoxide (CO)] from the Hefei City Ecology and Environment Bureau. Information on maternal hemoglobin levels, gestational anemia, iron supplementation, and PROM was obtained from medical records. Logistic regression models with distributed lags were used to identify the sensitive time window for the effect of prenatal exposure to air pollutant on PROM. Mediation analysis estimated the mediated effect of maternal hemoglobin in the third trimester, linking prenatal air pollution with PROM. Stratified analysis was used to investigate the potential effect of iron supplementation on PROM risk. Results: We found significant association between prenatal exposure to air pollution and increased PROM risk after adjusting for confounders, and the critical exposure windows of , , and CO were the 21th to 24th weeks of pregnancy. Every increase in and , increase in , and increase in CO was associated with low maternal hemoglobin levels [ (95% confidence interval (CI): , ), (95% CI: , ), (95% CI: , ), and (95% CI: , ), respectively] in the third trimester. The proportion of the association between air pollution and PROM risk mediated by hemoglobin levels was 20.61% [average mediation effect (95% CI): 0.02 (0.01, 0.05); average direct effect (95%): 0.08 (0.02, 0.14)]. The PROM risk associated with exposure to low-medium air pollution could be attenuated by maternal iron supplementation in women with gestational anemia. Conclusions: Prenatal exposure to air pollution, especially in the 21st to 24th weeks of pregnancy, is associated with PROM risk, which is partly mediated by maternal hemoglobin levels. Iron supplementation in anemia pregnancies may have protective effects again...

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“…Maternal air pollution exposure has been identified as the potential environmental risk factor of PROM ( Dadvand et al, 2014 ; Li et al, 2021a ; Pereira et al, 2014 ; Pereira et al, 2016 ; Song et al, 2019b ; Wallace et al, 2016 ; Wang et al, 2019 ; Zhang et al, 2021 ). Although results remain inconclusive, entire-pregnancy exposure to fine particulate matter < 2.5 μm (PM 2.5 ) and nitrogen dioxide (NO 2 ) were more commonly associated with elevated risks of PROM ( Dadvand et al, 2014 ; Pereira et al, 2014 ; Wang et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

The role of extreme heat exposure on premature rupture of membranes in Southern California: A study from a large pregnancy cohort

Jiao

Sun

Sacks

et al. 2023

Environment International

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Acute associations between air pollution on premature rupture of membranes in Hefei, China

Cited by 12 publications

References 51 publications

Air pollution and preterm birth: A time‐stratified case‐crossover study in the San Joaquin Valley of California

Air pollution and preterm birth: A time‐stratified case‐crossover study in the San Joaquin Valley of California

Prenatal Exposure to Air Pollution and Pre-Labor Rupture of Membranes in a Prospective Cohort Study: The Role of Maternal Hemoglobin and Iron Supplementation

The role of extreme heat exposure on premature rupture of membranes in Southern California: A study from a large pregnancy cohort

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