Maternal air pollution exposure and preterm birth in Wuxi, China: Effect modification by maternal age

Han, Yingying; Jiang, Panhua; Dong, Tianyu; Ding, Xinliang; Chen, Ting; Villanger, Gro Dehli; Aase, Heidi; Huang, Lu; Xia, Yankai

doi:10.1016/j.ecoenv.2018.04.002

Cited by 59 publications

(23 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the stratified analysis, we found that elderly pregnant women were at a high risk for ETB, which was consistent with the results of previous studies on adverse pregnancy outcomes in different maternal ages [35]. This result can be attributed to the aging of blood vessels in the reproductive system.…”

Section: Discussionsupporting

confidence: 91%

The Association between Preterm Birth and Ambient Air Pollution Exposure in Shiyan, China, 2015–2017

Chen

Ren

Liu

et al. 2021

IJERPH

View full text Add to dashboard Cite

Shortening of the gestational duration has been found associated with ambient air pollution exposure. However, the critical exposure windows of ambient air pollution for gestational duration remain inconsistent, and the association between ambient air pollution and early term births (ETB, 37 to 38 weeks) has rarely been studied relative to preterm births (PTB, 28–37 weeks). A time-series study was conducted in Shiyan, a medium-sized city in China. Birth information was collected from the Shiyan Maternity and Child Health Hospital, and 13,111 pregnant women who gave birth between 2015 and 2017 were included. Data of the concentrations of air pollutants, including PM10, PM2.5, NO2, and SO2 and meteorological data, were collected in the corresponding gestational period. The Cox regression analysis was performed to estimate the relationship between ambient air pollution exposure and the risk of preterm birth after controlling the confounders, including maternal age, education, Gravidity, parity, fetal gender, and delivery mode. Very preterm birth (VPTB, 28–32 weeks) as a subtype of PTB was also incorporated in this study. The risk of VPTB and ETB was positively associated with maternal ambient air pollution exposure, and the correlation of gaseous pollutants was stronger than particulate matter. With respect to exposure windows, the critical trimester of air pollutants for different adverse pregnancy outcomes was different. The exposure windows of PM10, PM2.5, and SO2 for ETB were found in the third trimester, with HRs (hazard ratios) of 1.06 (95%CI: 1.04, 1.09), 1.07 (95%CI: 1.04, 1.11), and 1.28 (95%CI: 1.20, 1.35), respectively. However, for NO2, the second and third trimesters exhibited similar results, the HRs reaching 1.10 (95%CI: 1.03, 6.17) and 1.09 (95%CI: 1.03,1.15), respectively. This study extends and strengthen the evidence for a significant correlation between the ambient air pollution exposure during pregnancy and the risk of not only PTB but, also, ETB. Moreover, our findings suggest that the exposure windows during pregnancy vary with different air pollutants and pregnancy outcomes.

show abstract

Section: Discussionsupporting

confidence: 91%

The Association between Preterm Birth and Ambient Air Pollution Exposure in Shiyan, China, 2015–2017

Chen

Ren

Liu

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Similarly, for the older age group, it's important to ask whether the higher risks are the results of age itself, of age accumulation of biological disadvantages such as hypertension and diabetes [27] that lead to pregnancy complications, of accumulation of unfavorable social-economic behaviors and environmental exposures like smoking and air pollution [33,34], or of a composite or interactions of the above [33,35]. The answer of this question is crucial for formulating public health policies and allocating public health resources in different maternal age groups.…”

Section: Discussionmentioning

confidence: 99%

“…The answer of this question is crucial for formulating public health policies and allocating public health resources in different maternal age groups. Some investigations state that the weathering effect is modi ed by the mother's socio-economic situation and tends to be most pronounced in women of lower socio-economic status [33]. If it's true, then it seems that the "weathering effect" for most APOs did be "modi ed" in Pinding and Xiyang County, indicating the relatively ne local maternal socio-economic situation.…”

Section: Discussionmentioning

confidence: 99%

Variation Trend of Adverse Pregnancy Outcomes in a High Prevalence Region of Birth Defects in Northern China from 2007 to 2012

Lin¹,

Zhang²,

Li³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Shanxi Province in northern China has been identified as an area with the highest prevalence of neural tube defects in the world; however, the constituent and prevalence of adverse pregnancy outcomes (APOs) has changed in recent years. The aim of our study was to investigate the constituent and variation trend of the birth prevalence of APOs in rural northern China.Methods A population-based descriptive study was conducted. Data were derived from two birth surveillance systems that recorded all pregnancy outcomes from 2007 to 2012 in Pingding and Xiyang County in Shanxi Province, China.Results From 2007 to 2012, the birth prevalence of APOs in the two counties was 154.7 per 1,000 births. The birth prevalence of neonatal death, stillbirths, birth defects, premature birth, low birth weight (LBW), and macrosomia was 3.4 per 1,000 births, 12.3 per 1,000 births, 12.2 per 1,000 births, 21.9 per 1,000 births, 40.5 per 1,000 births, and 64.5 per 1,000 births, respectively. Birth prevalence of macrosomia increased from 59.6 per 1,000 births in 2007 to 74.4 per 1,000 births in 2012( {\chi }_{trend}^{2} =20.314,P < 0.001). Birth prevalence of LBW and premature birth declined, from 43.8 per 1,000 births and 19.1 per 1,000 births in 2007 to 30.1 per 1,000 births and 11.8 per 1,000 births in 2012 ( {\chi }_{trend}^{2}=21.748, P < 0.001; {\chi }_{trend}^{2} =14.342, P < 0.001). The birth prevalence of neonatal death, stillbirth and birth defects stayed at a relatively low level. The distribution of APOs birth prevalence took an obvious “U-shape” as maternal age rose from <20 year to over 40 year except for macrosomia.Conclusions More efforts should be made on finding causes and ways of interventions on APOs, especially prematurity, LBW and macrosomia which are currently under insufficient attention.

show abstract

“…Common covariates included in many previous studies for adjustment were mother’s age, education, parity, prenatal care/health care coverage, race/ethnicity and the infant’s sex [20, 29–31]. Several studies indicated effect modification in the association between air pollution and adverse birth outcomes by maternal age, smoking, pre-pregnancy BMI and socioeconomic status (SES) [32–34]. This study aimed to explore potential effect modification by employment of mothers in the association between PM air pollution exposed for different stages of pregnancy and fetal growth restriction.…”

Section: Introductionmentioning

confidence: 99%

Association between ambient particulate matter concentration and fetal growth restriction stratified by maternal employment

Choe

Jang

Kim

et al. 2019

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Fetal growth has been known to be associated with particulate matter (PM) air pollution during gestation. Given that regular working may deviate outdoor air pollution exposure, the association between air pollution and fetal growth restriction can be different across maternal working status. This study was to assess possible effect modification by maternal employment in the association between exposure to PM during pregnancy and fetal growth restriction. Methods Using hourly PM less than or equal to 10 and 2.5 μm in diameter (PM 10 and PM 2.5 ) regulatory monitoring data for 2001–2012 and 2008–2012, respectively, and birth certificate data for 2002–2012, we computed maternal exposures with district-level averages of PM 10 and PM 2.5 during one year before birth, entire pregnancy, and the 1st, 2nd and 3rd trimesters. The outcomes of fetal growth restriction were assessed by small for gestational age (SGA, weighted <10th percentile in the same gestational age) as well as low birth weight (LBW, < 2.5 kg) at term. We performed logistic regression to examine the association between PM and each of fetal growth restriction outcomes adjusting for individual risk factors. For effect modification by maternal employment, we estimated adjusted odds ratio (OR) of SGA or LBW for interquartile (IQR) increases in PM 10 or PM 2.5 stratified by employed and non-employed mothers. We also computed relative excess risk due to interaction (RERI) to investigate additive interaction. Results Among 824,011 singleton term births, 34.0% (279,856) were employed and 66.0% (544,155) were non-employed mothers. Proportions of LBW were 1.5% in employed and 1.6% in non-employed ( P < 0.001). SGA occurred in 12.7% of employed and 12.8% of non- employed ( P = 0.124) mothers. For non-employed mothers, we observed increased odds of SGA per IQR increase in PM 10 for one year before birth (OR = 1.02, 95% confidence intervals (CI): 1.00–1.04, P = 0.028). ORs of SGA for full pregnancy period and the 3rd trimester were also positive but did not reach statistical significance. We did not observe positive association for PM 2.5 . RERI was not significant both for PM 10 and PM 2.5 . Conclusions We did not observe evidence of effect modification by maternal employment in the association between ambient PM and fetal growth restriction. Future studies using more refined exposure measures should confirm this finding. Electronic supplementary material The online version of this article (10.1186/s12884-019-2401-9) contains supplementary material, which is available to authorized...

show abstract

Maternal air pollution exposure and preterm birth in Wuxi, China: Effect modification by maternal age

Cited by 59 publications

References 46 publications

The Association between Preterm Birth and Ambient Air Pollution Exposure in Shiyan, China, 2015–2017

The Association between Preterm Birth and Ambient Air Pollution Exposure in Shiyan, China, 2015–2017

Variation Trend of Adverse Pregnancy Outcomes in a High Prevalence Region of Birth Defects in Northern China from 2007 to 2012

Association between ambient particulate matter concentration and fetal growth restriction stratified by maternal employment

Contact Info

Product

Resources

About