Modification effects of ambient temperature on associations of ambient ozone exposure before and during pregnancy with adverse birth outcomes: A multicity study in China

Chen, Juan; Guo, Liqiong; Liu, Huimeng; Jin, Lei; Wu, Meng; Fang, Junkai; Zhao, Lei; Zeng, Xiao‐Wen; Yang, Bo‐Yi; Wang, Qi; Guo, Xinbiao; Deng, Furong; Dong, Guang‐Hui; Shang, Xue‐Jun; Wu, Shaowei

doi:10.1016/j.envint.2023.107791

Cited by 13 publications

(3 citation statements)

References 71 publications

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“… 12 We lacked data on annual temperature, potentially impacting our estimates. 57 In addition, we did not have data on area-level socioeconomic status, and the possibility of residual confounding by other uncontrolled covariates cannot be excluded. Finally, preconception exposure windows varied across mothers, and we did not have a precise susceptibility window of the exposure.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes as related to in utero exposure to air pollution and greenness: The Life-GAP Project

Sinsamala,

Johannessen,

Bertelsen

et al. 2024

Environmental Epidemiology

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Background: Lower birth weight and preterm birth may increase the risk of adverse health outcomes later in life. We examined whether maternal exposure to air pollution and greenness during pregnancy is associated with offspring birth weight and preterm birth. Methods: We analyzed data on 4286 singleton births from 2358 mothers from Respiratory Health in Northern Europe, a prospective questionnaire-based cohort study (1990–2010). Mixed-effects regression models with random intercepts for mothers and centers were used to estimate the association of exposures to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), ozone (O3), black carbon (BC), and greenness (Normalized Difference Vegetation Index in 300m-buffers [NDVI300m]) with birth outcomes, adjusting for potential confounders. Results: Median (interquartile range [IQR]) exposures to PM2.5, PM10, NO2, O3, BC, and NDVI300m during pregnancy were 8.4(5.0) µg/m3, 14.4(8.3) µg/m3, 14.0(11.0) µg/m3, 54.7(10.2) µg/m3, 0.47(0.41) µg/m3, and 0.31(0.20), respectively. IQR increases in air pollution exposures during pregnancy were associated with decreased birth weight and the strongest association was seen for PM2.5 (−49g; 95% confidence interval [CI] = −83, −16). However, O3 showed an opposite association. IQR increase in NDVI300m was associated with an increase in birth weight of 25 g (95% CI = 7, 44). Preterm birth was not associated with the exposures. Conclusion: Increased greenness and decreased air pollution may contribute to healthier pregnancies and improve overall health in the next generation. This emphasizes the need to adopt policies that target the reduction of air pollution emissions and exposure of the population.

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Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes as related to in utero exposure to air pollution and greenness: The Life-GAP Project

Sinsamala,

Johannessen,

Bertelsen

et al. 2024

Environmental Epidemiology

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“…Previous studies have proven that elderly individuals are more vulnerable to air pollution and temperature variations. [27][28][29] Multiple chronic diseases and present declines in physiological processes make the elderly vulnerable to the modification effect of ozone on extreme high temperature. 30 Farmers engaged in agricultural work spend much more time outdoors, and their movement patterns may influence the exposure intensity of both ambient ozone and heat waves.…”

Section: Discussionmentioning

confidence: 99%

The modification effect of ozone pollution on the associations between heat wave and cardiovascular mortality

Qi,

Wang,

Wang

et al. 2023

TIME

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Epidemiological evidence concerning whether ozone modifies the impact of heat waves remain unexplored, especially in developing countries. To comprehensively evaluate the potential modification effect of ozone on heat wave impacts in warm seasons, we adopted a dataset (including mortality from overall cardiovascular diseases, chronic heart diseases and cerebrovascular diseases) in 250 Chinese cities from 2015 to 2019. A conditional quasi-Poisson regression model within the framework of the space-time-stratified case-crossover design was applied to obtain province-level associations, and a meta-analysis was adopted to pool province-level associations to national-average associations. Ozone concentration was categorized into low, medium and high levels using the 33rd and 66th percentiles of the location-specific levels as cutoffs, then we calculated the effect of heat waves in various ozone strata. Further stratification analyses on sub-populations (age group, sex and occupation) and regions were carried out. Heat waves were found to be positively associated with mortality from overall cardiovascular diseases (RR=1.043, 95% CI: 1.027-1.059). Higher concentrations of ozone significantly enhanced the effects of heat waves on cerebrovascular mortality. The mortality risk of heat waves was 1.071 (95% CI: 1.036-1.108) and 1.069 (95% CI: 1.039-1.100) at the medium and high levels, respectively (P for interaction=0.012 and 0.040, compared to the low level). A significant modification effect of ozone on the cerebrovascular mortality impact of heat waves was observed among people over 75, males and farmers, as well as in southern China and temperate climatic zones. Our findings suggest that ozone might potentially modify the mortality effect of heat waves.

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“…However, research that focused on the pregnant woman and the neonate, two groups of vulnerable population, is still limited. Literature has also reported strong associations between maternal exposure to various environmental factors and multiple types of APO [11][12][13][14][15][16] , but other pregnancy abnormalities (e.g. neonatal congenital heart disease, CHD) other than preterm birth (PTB), term low birth weight (LBW), and stillbirth have seldom been analysed.…”

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confidence: 99%

Maternal cardiovascular and haematological complications alter the risk associations between environmental exposure and adverse pregnancy outcomes

Sun,

Tang,

Zhao

et al. 2023

Preprint

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Given China’s recent introduction of the “three-child policy” in response to population ageing1, safeguarding perinatal health has become an urgent priority2. Previous epidemiological research seldom explored the risk factors of maternal cardiovascular and haematological diseases, or its impact on adverse pregnancy outcomes (APO). To fill the literature gap, here we conducted systematic epidemiological analyses on 121,090 pregnant women and their neonates from the ZEBRA Chinese prospective maternity cohort. We find that incremental exposure in PM2.5, O3, and green space modify the risks of APO, including congenital heart disease, by 11.2%, 7.8%, and –5.5%, respectively. Maternal cardiovascular and haematological complications during pregnancy significantly aggravate the risk of APO by 66.2%, and also modify the environment-APO risk associations by amplifying the hazards of air pollution and weakening the protective effect of greenness accessibility. Our research findings support the Sustainable Development Goals (e.g. SDG3)3,4by providing first-hand epidemiological evidence and clinical guidance for protecting maternal and neonatal health.

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Modification effects of ambient temperature on associations of ambient ozone exposure before and during pregnancy with adverse birth outcomes: A multicity study in China

Cited by 13 publications

References 71 publications

Pregnancy outcomes as related to in utero exposure to air pollution and greenness: The Life-GAP Project

Pregnancy outcomes as related to in utero exposure to air pollution and greenness: The Life-GAP Project

The modification effect of ozone pollution on the associations between heat wave and cardiovascular mortality

Maternal cardiovascular and haematological complications alter the risk associations between environmental exposure and adverse pregnancy outcomes

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