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Preterm birth and air pollution: Critical windows of exposure for women with asthma.
J Allergy Clin Immunol. 2016 08; 138(2):432-440.e5.JA

Abstract

BACKGROUND

Ambient air pollutants may increase preterm birth (PTB) risk, but critical exposure windows are uncertain. The interaction of asthma and pollutant exposure is rarely studied.

OBJECTIVE

We sought to assess the interaction of maternal asthma and air pollutant exposures in relation to PTB risk.

METHODS

Electronic medical records for 223,502 US deliveries were linked with modified Community Multiscale Air Quality model outputs. Logistic regression with generalized estimating equations estimated the odds ratio and 95% CIs for PTB on the basis of the interaction of maternal asthma and particulate matter with aerodynamic diameter of less than 2.5 microns and particulate matter with aerodynamic diameter of less than 10 microns, ozone (O3), nitrogen oxides (NOx), sulfur dioxide (SO2), and carbon monoxide (CO) per interquartile range. For each gestational week 23 to 36, exposures among women who delivered were compared with those remaining pregnant. Three-month preconception, whole pregnancy, weeks 1 to 28, and the last 6 weeks of gestation averages were also evaluated.

RESULTS

On assessing PTB by gestational week, we found that significant asthma interactions were sporadic before 30 weeks but more common during weeks 34 to 36, with higher risk among mothers with asthma for NOx, CO, and SO2 exposure and an inverse association with O3 in week 34. Odds of PTB were significantly higher among women with asthma for CO and NOx exposure preconception and early in pregnancy. In the last 6 weeks of pregnancy, PTB risk associated with particulate matter with aerodynamic diameter of less than 10 microns was higher among women with asthma.

CONCLUSIONS

Mothers with asthma may experience a higher risk for PTB after exposure to traffic-related pollutants such as CO and NOx, particularly for exposures 3-months preconception and in the early weeks of pregnancy.

Authors+Show Affiliations

Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md. Electronic address: pauline.mendola@nih.gov.Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md.Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md.Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md.Department of Behavioral and Community Health, University of North Texas Health Science Center, Fort Worth, Tex.Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu, Finland; Northern Finland Laboratory Centre Nordlab, Oulu, Finland; Department of Clinical Chemistry, University of Oulu, Oulu, Finland.Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md.The Emmes Corporation, Rockville, Md.Zachary Department of Civil Engineering, Texas A&M University, College Station, Tex.Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md.

Pub Type(s)

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

Language

eng

PubMed ID

26944405

Citation

Mendola, Pauline, et al. "Preterm Birth and Air Pollution: Critical Windows of Exposure for Women With Asthma." The Journal of Allergy and Clinical Immunology, vol. 138, no. 2, 2016, pp. 432-440.e5.
Mendola P, Wallace M, Hwang BS, et al. Preterm birth and air pollution: Critical windows of exposure for women with asthma. J Allergy Clin Immunol. 2016;138(2):432-440.e5.
Mendola, P., Wallace, M., Hwang, B. S., Liu, D., Robledo, C., Männistö, T., Sundaram, R., Sherman, S., Ying, Q., & Grantz, K. L. (2016). Preterm birth and air pollution: Critical windows of exposure for women with asthma. The Journal of Allergy and Clinical Immunology, 138(2), 432-e5. https://doi.org/10.1016/j.jaci.2015.12.1309
Mendola P, et al. Preterm Birth and Air Pollution: Critical Windows of Exposure for Women With Asthma. J Allergy Clin Immunol. 2016;138(2):432-440.e5. PubMed PMID: 26944405.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preterm birth and air pollution: Critical windows of exposure for women with asthma. AU - Mendola,Pauline, AU - Wallace,Maeve, AU - Hwang,Beom Seuk, AU - Liu,Danping, AU - Robledo,Candace, AU - Männistö,Tuija, AU - Sundaram,Rajeshwari, AU - Sherman,Seth, AU - Ying,Qi, AU - Grantz,Katherine L, Y1 - 2016/03/01/ PY - 2015/06/08/received PY - 2015/11/13/revised PY - 2015/12/01/accepted PY - 2016/3/6/entrez PY - 2016/3/6/pubmed PY - 2017/6/16/medline KW - Asthma KW - air pollution KW - pregnancy KW - preterm birth SP - 432 EP - 440.e5 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 138 IS - 2 N2 - BACKGROUND: Ambient air pollutants may increase preterm birth (PTB) risk, but critical exposure windows are uncertain. The interaction of asthma and pollutant exposure is rarely studied. OBJECTIVE: We sought to assess the interaction of maternal asthma and air pollutant exposures in relation to PTB risk. METHODS: Electronic medical records for 223,502 US deliveries were linked with modified Community Multiscale Air Quality model outputs. Logistic regression with generalized estimating equations estimated the odds ratio and 95% CIs for PTB on the basis of the interaction of maternal asthma and particulate matter with aerodynamic diameter of less than 2.5 microns and particulate matter with aerodynamic diameter of less than 10 microns, ozone (O3), nitrogen oxides (NOx), sulfur dioxide (SO2), and carbon monoxide (CO) per interquartile range. For each gestational week 23 to 36, exposures among women who delivered were compared with those remaining pregnant. Three-month preconception, whole pregnancy, weeks 1 to 28, and the last 6 weeks of gestation averages were also evaluated. RESULTS: On assessing PTB by gestational week, we found that significant asthma interactions were sporadic before 30 weeks but more common during weeks 34 to 36, with higher risk among mothers with asthma for NOx, CO, and SO2 exposure and an inverse association with O3 in week 34. Odds of PTB were significantly higher among women with asthma for CO and NOx exposure preconception and early in pregnancy. In the last 6 weeks of pregnancy, PTB risk associated with particulate matter with aerodynamic diameter of less than 10 microns was higher among women with asthma. CONCLUSIONS: Mothers with asthma may experience a higher risk for PTB after exposure to traffic-related pollutants such as CO and NOx, particularly for exposures 3-months preconception and in the early weeks of pregnancy. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/26944405/Preterm_birth_and_air_pollution:_Critical_windows_of_exposure_for_women_with_asthma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(16)00087-7 DB - PRIME DP - Unbound Medicine ER -