Exposure to airborne particulate matter during pregnancy is associated with preterm birth: A population-based cohort study

Emily DeFranco; William Moravec; Fan Xu; Eric Hall; Monir Hossain; Erin N. Haynes; Louis Muglia; Aimin Chen

doi:10.1186/s12940-016-0094-3

Exposure to airborne particulate matter during pregnancy is associated with preterm birth: A population-based cohort study

Emily DeFranco, William Moravec, Fan Xu, Eric Hall, Monir Hossain, Erin N. Haynes, Louis Muglia, Aimin Chen

Research output: Contribution to journal › Article › peer-review

83 Scopus citations

Abstract

Background: Test the hypothesis that exposure to fine particulate matter in the air (PM_2.5) is associated with increased risk of preterm birth (PTB). Methods: Geo-spatial population-based cohort study using live birth records from Ohio (2007-2010) linked to average daily measures of PM_2.5, recorded by 57 EPA network monitoring stations across the state. Geographic coordinates of the home residence for births were linked to the nearest monitoring station using ArcGIS. Association between PTB and high PM_2.5 levels (above the EPA annual standard of 15 μg/m³) was estimated using GEE, with adjustment for age, race, education, parity, insurance, tobacco, birth season and year, and infant gender. An exchangeable correlation matrix for the monitor stations was used in the models. Analyses were limited to non-anomalous singleton births at 20-42weeks with no known chromosome abnormality occurring within 10 km of a monitor station. Results: The frequency of PTB was 8.5 % in the study cohort of 224,921 singleton live births. High PM_2.5 exposure (>EPA recommended maximum) occurred frequently during the study period, with 24,662 women (11 %) having high exposure in all three trimesters. Pregnancies with high PM_2.5 exposure through pregnancy had increased PTB risk even after adjustment for coexisting risk factors, adjOR 1.19 (95 % CI 1.09-1.30). Assessed per trimester, high 3^rd trimester PM_2.5 exposure resulted in the highest PTB risk, adjOR 1.28 (95 % CI 1.20-1.37). Conclusions: Exposure to high levels of particulate air pollution, PM_2.5, in pregnancy is associated with a 19 % increased risk of PTB; with greatest risk with high 3^rd trimester exposure. Although the risk increase associated with high PM_2.5 levels is modest, the potential impact on overall PTB rates is robust as all pregnant women are potentially at risk. This exposure may in part contribute to the higher preterm birth rates in Ohio compared to other states in the US, especially in urban areas.

Original language	English
Article number	6
Journal	Environmental Health: A Global Access Science Source
Volume	15
Issue number	1
DOIs	https://doi.org/10.1186/s12940-016-0094-3
State	Published - Jan 15 2016

Bibliographical note

Publisher Copyright:
© 2016 DeFranco et al.

Funding

This work was supported by the Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA, and March of Dimes Grant 22-FY13-543 for the March of Dimes Prematurity Research Center Ohio Collaborative. The funding sources for this study were not involved in the design or conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript. The decision to submit this manuscript for publication was made by the study authors without influence from the funding source. This study includes data provided by the Ohio Department of Health which should not be considered an endorsement of this study or its conclusions.

Funders	Funder number
Perinatal Institute
National Institutes of Health/National Institute of Environmental Health Sciences	P30ES006096
March of Dimes Research Foundation	22-FY13-543
Cincinnati Children's Hospital Medical Center
March of Dimes Prematurity Research Center Ohio Collaborative

Keywords

Air pollution
PTB
Particulate matter
Prematurity
Preterm birth

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Health, Toxicology and Mutagenesis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12940-016-0094-3

Cite this

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title = "Exposure to airborne particulate matter during pregnancy is associated with preterm birth: A population-based cohort study",

abstract = "Background: Test the hypothesis that exposure to fine particulate matter in the air (PM2.5) is associated with increased risk of preterm birth (PTB). Methods: Geo-spatial population-based cohort study using live birth records from Ohio (2007-2010) linked to average daily measures of PM2.5, recorded by 57 EPA network monitoring stations across the state. Geographic coordinates of the home residence for births were linked to the nearest monitoring station using ArcGIS. Association between PTB and high PM2.5 levels (above the EPA annual standard of 15 μg/m3) was estimated using GEE, with adjustment for age, race, education, parity, insurance, tobacco, birth season and year, and infant gender. An exchangeable correlation matrix for the monitor stations was used in the models. Analyses were limited to non-anomalous singleton births at 20-42weeks with no known chromosome abnormality occurring within 10 km of a monitor station. Results: The frequency of PTB was 8.5 % in the study cohort of 224,921 singleton live births. High PM2.5 exposure (>EPA recommended maximum) occurred frequently during the study period, with 24,662 women (11 %) having high exposure in all three trimesters. Pregnancies with high PM2.5 exposure through pregnancy had increased PTB risk even after adjustment for coexisting risk factors, adjOR 1.19 (95 % CI 1.09-1.30). Assessed per trimester, high 3rd trimester PM2.5 exposure resulted in the highest PTB risk, adjOR 1.28 (95 % CI 1.20-1.37). Conclusions: Exposure to high levels of particulate air pollution, PM2.5, in pregnancy is associated with a 19 % increased risk of PTB; with greatest risk with high 3rd trimester exposure. Although the risk increase associated with high PM2.5 levels is modest, the potential impact on overall PTB rates is robust as all pregnant women are potentially at risk. This exposure may in part contribute to the higher preterm birth rates in Ohio compared to other states in the US, especially in urban areas.",

keywords = "Air pollution, PTB, Particulate matter, Prematurity, Preterm birth",

author = "Emily DeFranco and William Moravec and Fan Xu and Eric Hall and Monir Hossain and Haynes, {Erin N.} and Louis Muglia and Aimin Chen",

note = "Publisher Copyright: {\textcopyright} 2016 DeFranco et al.",

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day = "15",

doi = "10.1186/s12940-016-0094-3",

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T1 - Exposure to airborne particulate matter during pregnancy is associated with preterm birth

T2 - A population-based cohort study

AU - DeFranco, Emily

AU - Moravec, William

AU - Xu, Fan

AU - Hall, Eric

AU - Hossain, Monir

AU - Haynes, Erin N.

AU - Muglia, Louis

AU - Chen, Aimin

PY - 2016/1/15

Y1 - 2016/1/15

N2 - Background: Test the hypothesis that exposure to fine particulate matter in the air (PM2.5) is associated with increased risk of preterm birth (PTB). Methods: Geo-spatial population-based cohort study using live birth records from Ohio (2007-2010) linked to average daily measures of PM2.5, recorded by 57 EPA network monitoring stations across the state. Geographic coordinates of the home residence for births were linked to the nearest monitoring station using ArcGIS. Association between PTB and high PM2.5 levels (above the EPA annual standard of 15 μg/m3) was estimated using GEE, with adjustment for age, race, education, parity, insurance, tobacco, birth season and year, and infant gender. An exchangeable correlation matrix for the monitor stations was used in the models. Analyses were limited to non-anomalous singleton births at 20-42weeks with no known chromosome abnormality occurring within 10 km of a monitor station. Results: The frequency of PTB was 8.5 % in the study cohort of 224,921 singleton live births. High PM2.5 exposure (>EPA recommended maximum) occurred frequently during the study period, with 24,662 women (11 %) having high exposure in all three trimesters. Pregnancies with high PM2.5 exposure through pregnancy had increased PTB risk even after adjustment for coexisting risk factors, adjOR 1.19 (95 % CI 1.09-1.30). Assessed per trimester, high 3rd trimester PM2.5 exposure resulted in the highest PTB risk, adjOR 1.28 (95 % CI 1.20-1.37). Conclusions: Exposure to high levels of particulate air pollution, PM2.5, in pregnancy is associated with a 19 % increased risk of PTB; with greatest risk with high 3rd trimester exposure. Although the risk increase associated with high PM2.5 levels is modest, the potential impact on overall PTB rates is robust as all pregnant women are potentially at risk. This exposure may in part contribute to the higher preterm birth rates in Ohio compared to other states in the US, especially in urban areas.

AB - Background: Test the hypothesis that exposure to fine particulate matter in the air (PM2.5) is associated with increased risk of preterm birth (PTB). Methods: Geo-spatial population-based cohort study using live birth records from Ohio (2007-2010) linked to average daily measures of PM2.5, recorded by 57 EPA network monitoring stations across the state. Geographic coordinates of the home residence for births were linked to the nearest monitoring station using ArcGIS. Association between PTB and high PM2.5 levels (above the EPA annual standard of 15 μg/m3) was estimated using GEE, with adjustment for age, race, education, parity, insurance, tobacco, birth season and year, and infant gender. An exchangeable correlation matrix for the monitor stations was used in the models. Analyses were limited to non-anomalous singleton births at 20-42weeks with no known chromosome abnormality occurring within 10 km of a monitor station. Results: The frequency of PTB was 8.5 % in the study cohort of 224,921 singleton live births. High PM2.5 exposure (>EPA recommended maximum) occurred frequently during the study period, with 24,662 women (11 %) having high exposure in all three trimesters. Pregnancies with high PM2.5 exposure through pregnancy had increased PTB risk even after adjustment for coexisting risk factors, adjOR 1.19 (95 % CI 1.09-1.30). Assessed per trimester, high 3rd trimester PM2.5 exposure resulted in the highest PTB risk, adjOR 1.28 (95 % CI 1.20-1.37). Conclusions: Exposure to high levels of particulate air pollution, PM2.5, in pregnancy is associated with a 19 % increased risk of PTB; with greatest risk with high 3rd trimester exposure. Although the risk increase associated with high PM2.5 levels is modest, the potential impact on overall PTB rates is robust as all pregnant women are potentially at risk. This exposure may in part contribute to the higher preterm birth rates in Ohio compared to other states in the US, especially in urban areas.

KW - Air pollution

KW - PTB

KW - Particulate matter

KW - Prematurity

KW - Preterm birth

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Exposure to airborne particulate matter during pregnancy is associated with preterm birth: A population-based cohort study

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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