This paper uses a novel air pollution modelling technique to capture strong spatial and temporal resolution in order to assign exposure estimates to a large cohort, reducing the risk of exposure misclassification. The association between air pollution and adverse pregnancy outcomes is quantified in North West England -an area where this has not been investigated before.
Affiliation
518Scand J Work Environ Health 2014, vol 40, no 5 Original article Scand J Work Environ Health. 2014;40(5):518-530. doi:10.5271/sjweh.3423 Air pollution exposure and adverse pregnancy outcomes in a large UK birth cohort: use of a novel spatio-temporal modelling technique By Kimberly Hannam, PhD,1,2, 3 Roseanne McNamee, PhD, 3 Philip Baker, MD, 4 Colin Sibley, PhD,1, 2 Raymond Agius, MD 5 Hannam K, McNamee R, Baker P, Sibley C, Agius R. Air pollution exposure and adverse pregnancy outcomes in a large UK birth cohort: use of a novel spatio-temporal modelling technique. Scand J Work Environ Health. 2014;40(5):518-530 doi:10.5271/sjweh.3423Objectives Previous work suggests an association between air pollution exposure and adverse pregnancy outcomes, even at relatively low concentrations. Our aim was to quantify the effect of air pollution having an adverse effect on preterm birth (PTB) and fetal growth in a large UK cohort using a novel exposure estimation technique [spatio-temporal (S-T) model] alongside a traditional nearest stationary monitor technique (NSTAT).Methods All available postcodes from a Northwest England birth outcome dataset during 2004-2008 were geocoded (N=203 562 deliveries). Pollution estimates were linked to corresponding pregnancy periods using temporally adjusted background modelled concentrations as well as NSTAT. Associations with PTB, small for gestational age (SGA), and birth weight were investigated using regression models adjusting for maternal age, ethnicity, parity, birth season, socioeconomic status (SES), body mass index (BMI), and smoking.Results Based on the novel S-T model, a small statistically significant association was observed for particulate matter (PM 10 ) and SGA, particularly with exposure in the first and third trimesters. Similar effects on SGA were also found for nitrogen dioxide (NO 2 ), particulate matter (PM 2,5 ), and carbon monoxide (CO) in later pregnancy, but no overall increased risk was observed. No associations were found with NO x or the outcomes PTB and reduction in birth weight.
ConclusionOur findings suggest an association between air pollution exposure and birth of a SGA infant, particularly in the later stages of pregnancy but not with PTB or mean birth weight change.Key terms England; exposure estimation; preterm birth; SGA; small-for-gestational age; spatio-temporal model. Pregnancy outcome is determined by the ability of the fetus to thrive, which depends on a complex combination of genetic, social, and environmental factors (1). If, during pregnancy, a mother is exposed to increased environmental or social stressors, this could result in an increased risk of re...