The Association between Preterm Birth and Ambient Air Pollution Exposure in Shiyan, China, 2015–2017

Qihao Chen, Zhan Ren, Yujie Liu, Yunfei Qiu, Haomin Yang, Yuren Zhou, Xiaodie Wang, Kuizhuang Jiao, Jingling Liao and Lu Ma
Additional contact information
Qihao Chen: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China
Zhan Ren: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China
Yujie Liu: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China
Yunfei Qiu: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China
Haomin Yang: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China
Yuren Zhou: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China
Xiaodie Wang: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China
Kuizhuang Jiao: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China
Jingling Liao: Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430081, China
Lu Ma: Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430072, China

IJERPH, 2021, vol. 18, issue 8, 1-14

Abstract: Shortening of the gestational duration has been found associated with ambient air pollution exposure. However, the critical exposure windows of ambient air pollution for gestational duration remain inconsistent, and the association between ambient air pollution and early term births (ETB, 37 to 38 weeks) has rarely been studied relative to preterm births (PTB, 28–37 weeks). A time-series study was conducted in Shiyan, a medium-sized city in China. Birth information was collected from the Shiyan Maternity and Child Health Hospital, and 13,111 pregnant women who gave birth between 2015 and 2017 were included. Data of the concentrations of air pollutants, including PM 10 , PM 2.5 , NO 2 , and SO 2 and meteorological data, were collected in the corresponding gestational period. The Cox regression analysis was performed to estimate the relationship between ambient air pollution exposure and the risk of preterm birth after controlling the confounders, including maternal age, education, Gravidity, parity, fetal gender, and delivery mode. Very preterm birth (VPTB, 28–32 weeks) as a subtype of PTB was also incorporated in this study. The risk of VPTB and ETB was positively associated with maternal ambient air pollution exposure, and the correlation of gaseous pollutants was stronger than particulate matter. With respect to exposure windows, the critical trimester of air pollutants for different adverse pregnancy outcomes was different. The exposure windows of PM 10 , PM 2.5 , and SO 2 for ETB were found in the third trimester, with HRs (hazard ratios) of 1.06 (95%CI: 1.04, 1.09), 1.07 (95%CI: 1.04, 1.11), and 1.28 (95%CI: 1.20, 1.35), respectively. However, for NO 2 , the second and third trimesters exhibited similar results, the HRs reaching 1.10 (95%CI: 1.03, 6.17) and 1.09 (95%CI: 1.03,1.15), respectively. This study extends and strengthen the evidence for a significant correlation between the ambient air pollution exposure during pregnancy and the risk of not only PTB but, also, ETB. Moreover, our findings suggest that the exposure windows during pregnancy vary with different air pollutants and pregnancy outcomes.

Keywords: air pollution; preterm birth; early term birth (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/8/4326/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/8/4326/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:8:p:4326-:d:539079

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().