Benzene and NO 2 Exposure during Pregnancy and Preterm Birth in Two Philadelphia Hospitals, 2013–2017

Kathleen M. Escoto (), Anne M. Mullin, Rachel Ledyard, Elizabeth Rovit, Nancy Yang, Sheila Tripathy, Heather H. Burris and Jane E. Clougherty
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Kathleen M. Escoto: Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
Anne M. Mullin: School of Medicine, Tufts University, Boston, MA 02111, USA
Rachel Ledyard: Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
Elizabeth Rovit: Center for Public Health Initiatives, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
Nancy Yang: Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
Sheila Tripathy: Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
Heather H. Burris: Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
Jane E. Clougherty: Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA

IJERPH, 2022, vol. 19, issue 16, 1-11

Abstract: Infants born preterm are at risk of neonatal morbidity and mortality. Preterm birth (PTB) can be categorized as either spontaneous (sPTB) or medically indicated (mPTB), resulting from distinct pathophysiologic processes such as preterm labor or preeclampsia, respectively. A growing body of literature has demonstrated the impacts of nitrogen dioxide (NO 2 ) and benzene exposure on PTB, though few studies have investigated how these associations may differ by PTB subtype. We investigated the associations of NO 2 and benzene exposure with sPTB and mPTB among 18,616 singleton live births at two Philadelphia hospitals between 2013 and 2017. Residential NO 2 exposure was estimated using a land use regression model and averaged over the patient’s full pregnancy. Benzene exposure was estimated at the census tract level using National Air Toxics Assessment (NATA) exposure data from 2014. We used logistic mixed-effects models to calculate odds ratios for overall PTB, sPTB, and mPTB separately, adjusting for patient- and tract-level confounders. Given the known racial segregation and PTB disparities in Philadelphia, we also examined race-stratified models. Counter to the hypothesis, neither NO 2 nor benzene exposure differed by race, and neither were significantly associated with PTB or PTB subtypes. As such, these pollutants do not appear to explain the racial disparities in PTB in this setting.

Keywords: NO 2; nitrogen dioxide; benzene; preterm birth; Philadelphia; spontaneous preterm birth; medically indicated preterm birth (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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