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Ambient air pollution and preterm birth: A prospective birth cohort study in Wuhan, China.
Int J Hyg Environ Health. 2016 Mar; 219(2):195-203.IJ

Abstract

IMPORTANCE

Although studies in western countries suggest that ambient air pollution is positively associated with adverse pregnancy outcomes, the upper levels of pollutant exposures have been relatively low, thus eroding confidence in the conclusions. Meanwhile, in Asia, where upper levels of exposure have been greater, there have been limited studies of the association between air pollution and adverse pregnancy outcomes.

OBJECTIVE

The primary objective was to evaluate whether high levels of pollution, including particulate matter pollution with a mass median aerodynamic diameter of less than 2.5 μm (PM2.5) and 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) are related to increased occurrence of preterm birth (PTB).

METHODS

We conducted a population-based study in Wuhan, China in a cohort of 95,911 live births during a two-year period from 2011 to 2013. The exposure was estimated based on daily mean concentrations of pollutants estimated using the pollutants' measurements from the nine closest monitors. Logistic regressions were performed to determine the relationships between exposure to each of the pollutants during different pregnancy periods and PTB while controlling for key covariates.

RESULTS

We found 3% (OR=1.03; 95% CI: 1.02, 1.05), 2% (OR=1.02; 95% CI: 1.02, 1.03), 15% (OR=1.15; 95% CI: 1.11, 1.19), and 5% (OR=1.05; 95% CI: 1.02, 1.07) increases in risk of PTB with each 5-μg/m(3) increase in PM2.5 and PM10 concentrations, 100-μg/m(3) increase in CO concentrations, and 10-μg/m(3) increase in O3 concentrations, respectively. There was negligible evidence for associations for SO2 and NO2. The effects from two-pollutant models were similar to the estimated effects from single pollutant models. No critical exposure windows were identified consistently: the strongest effect for PTB was found in the second trimester for PM2.5, PM10, and CO, but for SO2 it was in the first trimester, second month, and third month. For NO2 it was in the first trimester and second month, and for O3, the third trimester.

CONCLUSION

Findings reveal an association between air pollutants and PTB. However, more toxicological studies and prospective cohort studies with improved exposure assessments are needed to establish causality related to specific pollutants.

Authors+Show Affiliations

College for Public Health and Social Justice, Saint Louis University, Salus Center/Room 473, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA. Electronic address: zqian2@slu.edu.Wuhan Environmental Monitoring Center, 422 Xinhua Road, Jianghan District, Wuhan 430015, China.Wuhan Medical and Health Center for Women and Children, 100 Hongkong Road, Jiangan District, Wuhan 430015, China.College for Public Health and Social Justice, Saint Louis University, Salus Center/Room 473, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA.Wuhan Environmental Monitoring Center, 422 Xinhua Road, Jianghan District, Wuhan 430015, China.Wuhan Medical and Health Center for Women and Children, 100 Hongkong Road, Jiangan District, Wuhan 430015, China.College for Public Health and Social Justice, Saint Louis University, Salus Center/Room 473, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA.Wuhan Environmental Monitoring Center, 422 Xinhua Road, Jianghan District, Wuhan 430015, China.Wuhan Medical and Health Center for Women and Children, 100 Hongkong Road, Jiangan District, Wuhan 430015, China.College for Public Health and Social Justice, Saint Louis University, Salus Center/Room 473, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA.Wuhan Environmental Monitoring Center, 422 Xinhua Road, Jianghan District, Wuhan 430015, China.Wuhan Medical and Health Center for Women and Children, 100 Hongkong Road, Jiangan District, Wuhan 430015, China.Wuhan Environmental Monitoring Center, 422 Xinhua Road, Jianghan District, Wuhan 430015, China.College for Public Health and Social Justice, Saint Louis University, Salus Center/Room 473, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA.Wuhan Medical and Health Center for Women and Children, 100 Hongkong Road, Jiangan District, Wuhan 430015, China.Wuhan Medical and Health Center for Women and Children, 100 Hongkong Road, Jiangan District, Wuhan 430015, China.Wuhan Medical and Health Center for Women and Children, 100 Hongkong Road, Jiangan District, Wuhan 430015, China.School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China.School of Public Health, Brown University, 121 South Main Street, Providence, RI 02912, USA.School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan 430030, China.Wuhan Medical and Health Center for Women and Children, 100 Hongkong Road, Jiangan District, Wuhan 430015, China. Electronic address: mchwhzb@163.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26639560

Citation

Qian, Zhengmin, et al. "Ambient Air Pollution and Preterm Birth: a Prospective Birth Cohort Study in Wuhan, China." International Journal of Hygiene and Environmental Health, vol. 219, no. 2, 2016, pp. 195-203.
Qian Z, Liang S, Yang S, et al. Ambient air pollution and preterm birth: A prospective birth cohort study in Wuhan, China. Int J Hyg Environ Health. 2016;219(2):195-203.
Qian, Z., Liang, S., Yang, S., Trevathan, E., Huang, Z., Yang, R., Wang, J., Hu, K., Zhang, Y., Vaughn, M., Shen, L., Liu, W., Li, P., Ward, P., Yang, L., Zhang, W., Chen, W., Dong, G., Zheng, T., ... Zhang, B. (2016). Ambient air pollution and preterm birth: A prospective birth cohort study in Wuhan, China. International Journal of Hygiene and Environmental Health, 219(2), 195-203. https://doi.org/10.1016/j.ijheh.2015.11.003
Qian Z, et al. Ambient Air Pollution and Preterm Birth: a Prospective Birth Cohort Study in Wuhan, China. Int J Hyg Environ Health. 2016;219(2):195-203. PubMed PMID: 26639560.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ambient air pollution and preterm birth: A prospective birth cohort study in Wuhan, China. AU - Qian,Zhengmin, AU - Liang,Shengwen, AU - Yang,Shaoping, AU - Trevathan,Edwin, AU - Huang,Zhen, AU - Yang,Rong, AU - Wang,Jing, AU - Hu,Ke, AU - Zhang,Yiming, AU - Vaughn,Michael, AU - Shen,Longjiao, AU - Liu,Wenjin, AU - Li,Pu, AU - Ward,Patrick, AU - Yang,Li, AU - Zhang,Wei, AU - Chen,Wei, AU - Dong,Guanghui, AU - Zheng,Tongzhang, AU - Xu,Shunqing, AU - Zhang,Bin, Y1 - 2015/11/19/ PY - 2015/08/05/received PY - 2015/11/13/revised PY - 2015/11/14/accepted PY - 2015/12/8/entrez PY - 2015/12/8/pubmed PY - 2016/10/25/medline KW - Air pollution KW - Birth cohort KW - Preterm birth KW - Wuhan SP - 195 EP - 203 JF - International journal of hygiene and environmental health JO - Int J Hyg Environ Health VL - 219 IS - 2 N2 - IMPORTANCE: Although studies in western countries suggest that ambient air pollution is positively associated with adverse pregnancy outcomes, the upper levels of pollutant exposures have been relatively low, thus eroding confidence in the conclusions. Meanwhile, in Asia, where upper levels of exposure have been greater, there have been limited studies of the association between air pollution and adverse pregnancy outcomes. OBJECTIVE: The primary objective was to evaluate whether high levels of pollution, including particulate matter pollution with a mass median aerodynamic diameter of less than 2.5 μm (PM2.5) and 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) are related to increased occurrence of preterm birth (PTB). METHODS: We conducted a population-based study in Wuhan, China in a cohort of 95,911 live births during a two-year period from 2011 to 2013. The exposure was estimated based on daily mean concentrations of pollutants estimated using the pollutants' measurements from the nine closest monitors. Logistic regressions were performed to determine the relationships between exposure to each of the pollutants during different pregnancy periods and PTB while controlling for key covariates. RESULTS: We found 3% (OR=1.03; 95% CI: 1.02, 1.05), 2% (OR=1.02; 95% CI: 1.02, 1.03), 15% (OR=1.15; 95% CI: 1.11, 1.19), and 5% (OR=1.05; 95% CI: 1.02, 1.07) increases in risk of PTB with each 5-μg/m(3) increase in PM2.5 and PM10 concentrations, 100-μg/m(3) increase in CO concentrations, and 10-μg/m(3) increase in O3 concentrations, respectively. There was negligible evidence for associations for SO2 and NO2. The effects from two-pollutant models were similar to the estimated effects from single pollutant models. No critical exposure windows were identified consistently: the strongest effect for PTB was found in the second trimester for PM2.5, PM10, and CO, but for SO2 it was in the first trimester, second month, and third month. For NO2 it was in the first trimester and second month, and for O3, the third trimester. CONCLUSION: Findings reveal an association between air pollutants and PTB. However, more toxicological studies and prospective cohort studies with improved exposure assessments are needed to establish causality related to specific pollutants. SN - 1618-131X UR - https://www.unboundmedicine.com/medline/citation/26639560/Ambient_air_pollution_and_preterm_birth:_A_prospective_birth_cohort_study_in_Wuhan_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1438-4639(15)00153-4 DB - PRIME DP - Unbound Medicine ER -