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Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City.
Epidemiology. 2015 Sep; 26(5):748-57.E

Abstract

BACKGROUND

Previous studies suggested a possible association between fine particulate matter air pollution (PM2.5) and nitrogen dioxide (NO2) and the development of hypertensive disorders of pregnancy, but effect sizes have been small and methodologic weaknesses preclude firm conclusions.

METHODS

We linked birth certificates in New York City in 2008-2010 to hospital discharge diagnoses and estimated air pollution exposure based on maternal address. The New York City Community Air Survey provided refined estimates of PM2.5 and NO2 at the maternal residence. We estimated the association between exposures to PM2.5 and NO2 in the first and second trimester and risk of gestational hypertension, mild preeclampsia, and severe preeclampsia among 268,601 births.

RESULTS

In unadjusted analyses, we found evidence of a positive association between both pollutants and gestational hypertension. However, after adjustment for individual covariates, socioeconomic deprivation, and delivery hospital, we did not find evidence of an association between PM2.5 or NO2 in the first or second trimester and any of the outcomes.

CONCLUSIONS

Our data did not provide clear evidence of an effect of ambient air pollution on hypertensive disorders of pregnancy. Results need to be interpreted with caution considering the quality of the available exposure and health outcome measures and the uncertain impact of adjusting for hospital. Relative to previous studies, which have tended to identify positive associations with PM2.5 and NO2, our large study size, refined air pollution exposure estimates, hospital-based disease ascertainment, and little risk of confounding by socioeconomic deprivation, does not provide evidence for an association.

Authors+Show Affiliations

From the aDepartments of Epidemiology and Obstetrics and Gynecology, Brown University, Providence, RI; bDepartment of Epidemiology, Brown University, Providence, RI; cDepartment of Biostatistics, Harvard School of Public Health, Boston, MA; dDepartment of Occupational and Environmental Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; eNew York City Department of Health and Mental Hygiene, New York, NY; and f ZevRoss Spatial Analysis, Ithaca, NY.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26237745

Citation

Savitz, David A., et al. "Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City." Epidemiology (Cambridge, Mass.), vol. 26, no. 5, 2015, pp. 748-57.
Savitz DA, Elston B, Bobb JF, et al. Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City. Epidemiology. 2015;26(5):748-57.
Savitz, D. A., Elston, B., Bobb, J. F., Clougherty, J. E., Dominici, F., Ito, K., Johnson, S., McAlexander, T., Ross, Z., Shmool, J. L., Matte, T. D., & Wellenius, G. A. (2015). Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City. Epidemiology (Cambridge, Mass.), 26(5), 748-57. https://doi.org/10.1097/EDE.0000000000000349
Savitz DA, et al. Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City. Epidemiology. 2015;26(5):748-57. PubMed PMID: 26237745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City. AU - Savitz,David A, AU - Elston,Beth, AU - Bobb,Jennifer F, AU - Clougherty,Jane E, AU - Dominici,Francesca, AU - Ito,Kazuhiko, AU - Johnson,Sarah, AU - McAlexander,Tara, AU - Ross,Zev, AU - Shmool,Jessie L C, AU - Matte,Thomas D, AU - Wellenius,Gregory A, PY - 2015/8/4/entrez PY - 2015/8/4/pubmed PY - 2016/5/5/medline SP - 748 EP - 57 JF - Epidemiology (Cambridge, Mass.) JO - Epidemiology VL - 26 IS - 5 N2 - BACKGROUND: Previous studies suggested a possible association between fine particulate matter air pollution (PM2.5) and nitrogen dioxide (NO2) and the development of hypertensive disorders of pregnancy, but effect sizes have been small and methodologic weaknesses preclude firm conclusions. METHODS: We linked birth certificates in New York City in 2008-2010 to hospital discharge diagnoses and estimated air pollution exposure based on maternal address. The New York City Community Air Survey provided refined estimates of PM2.5 and NO2 at the maternal residence. We estimated the association between exposures to PM2.5 and NO2 in the first and second trimester and risk of gestational hypertension, mild preeclampsia, and severe preeclampsia among 268,601 births. RESULTS: In unadjusted analyses, we found evidence of a positive association between both pollutants and gestational hypertension. However, after adjustment for individual covariates, socioeconomic deprivation, and delivery hospital, we did not find evidence of an association between PM2.5 or NO2 in the first or second trimester and any of the outcomes. CONCLUSIONS: Our data did not provide clear evidence of an effect of ambient air pollution on hypertensive disorders of pregnancy. Results need to be interpreted with caution considering the quality of the available exposure and health outcome measures and the uncertain impact of adjusting for hospital. Relative to previous studies, which have tended to identify positive associations with PM2.5 and NO2, our large study size, refined air pollution exposure estimates, hospital-based disease ascertainment, and little risk of confounding by socioeconomic deprivation, does not provide evidence for an association. SN - 1531-5487 UR - https://www.unboundmedicine.com/medline/citation/26237745/Ambient_Fine_Particulate_Matter_Nitrogen_Dioxide_and_Hypertensive_Disorders_of_Pregnancy_in_New_York_City_ L2 - https://doi.org/10.1097/EDE.0000000000000349 DB - PRIME DP - Unbound Medicine ER -