Measuring Burden of Disease Attributable to Air Pollution Due to Preterm Birth Complications and Infant Death in Paris Using Disability-Adjusted Life Years (DALYs)

Abstract

Several studies have found maternal exposure to particulate matter pollution was associated with adverse birth outcomes, including infant mortality and preterm birth. In this context, our study aims to quantify the air pollution burden of disease due to preterm birth complications and infant death in Paris, with particular attention to people living in the most deprived census blocks. Data on infant death and preterm birth was available from the birth and death certificates. The postal address of mother’s newborn was converted in census block number. A socioeconomic deprivation index was built at the census block level. Average annual ambient concentrations of PM10 were modelled at census block level using the ESMERALDA atmospheric modelling system. The number of infant deaths attributed to PM10 exposure is expressed in years of life lost. We used a three-step compartmental model to appraise neurodevelopmental impairment among survivors of preterm birth. We estimated that 12.8 infant deaths per 100,000 live births may be attributable to PM10 exposure, and about one third of these infants lived in deprived census blocks. In addition, we found that approximately 4.8% of preterm births could be attributable to PM10 exposure, and approximately 1.9% of these infants died (corresponding to about 5.75 deaths per 100,000 live birth). Quantification of environmental hazard-related health impacts for children at local level is essential to prioritizing interventions. Our study suggests that additional effort is needed to reduce the risk of complications and deaths related to air pollution exposure, especially among preterm births. Because of widespread exposure to air pollution, significant health benefits could be achieved through regulatory interventions aimed at reducing exposure of the population as a whole, and particularly of the most vulnerable, such as children and pregnant women.

The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019

“…One study estimated the annual cost of preterm birth as $25 billion in 2016 [ 6 ]. Factors that have been found related to the preterm birth rate include maternal stress [ 7 ], air pollution [ 8 ], rural residential area [ 9 ], young maternal age [ 10 ] and social determinants [ 11 ]. Proposed remedies for the problem have ranged from social programs [ 12 ] to low dose aspirin [ 13 ], precision medicine [ 14 ] and progesterone vaginal tablets [ 15 ].…”