Shaoping Yang1, Yafei Tan1, Hui Mei1, Fang Wang1, Na Li1, Jinzhu Zhao1, Yiming Zhang1, Zhengmin Qian2, Jen Jen Chang2, Kevin M Syberg2, Anna Peng1, Hong Mei1, Dan Zhang1, Yan Zhang1, Shunqing Xu3, Yuanyuan Li3, Tongzhang Zheng4, Bin Zhang5. 1. Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Jiangan District, Wuhan, China. 2. College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, USA. 3. Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 4. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA. 5. Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Jiangan District, Wuhan, China. Electronic address: 2500070378@qq.com.
Abstract
BACKGROUND: Recent studies suggest that ambient air pollution exposure during pregnancy is associated with stillbirth occurrence. However, the results on the associations between ambient air pollutants and stillbirths are inconsistent and little is known about the gestational timing of sensitive periods for the effects of ambient air pollutants exposure on stillbirth. OBJECTIVE: This study aimed to examine whether exposure to high levels of ambient air pollutants in a Chinese population is associated with an increased risk of stillbirth, and determine the gestational period when the fetus is most susceptible. METHODS: We conducted a population-based cohort study in Wuhan, China, involving 95,354 births between June 10, 2011 and June 9, 2013. The exposure assessments were based on the daily mean concentrations of air pollutants obtained from the exposure monitor nearest to the pregnant women's residence. Logistic regression analyses were performed to determine the associations between stillbirths and exposure to each of the air pollutants at different pregnancy periods with adjustment for confounding factors. RESULTS: Stillbirth increased with a 10 μg/m3 increase in particulate matter 2.5 (PM2.5) in each stage of pregnancy, and a significant association between carbon monoxide (CO) exposure and stillbirth was found during the third trimester (adjusted odds ratio (aOR): 1.01, 95% confidence interval (CI): 1.00-1.01) and in the entire pregnancy (aOR: 1.18, 95% CI: 1.04-1.34). Furthermore, an increased risk of stillbirth in the third trimester was associated with a 10 μg/m3 increase in PM10 (aOR: 1.08, 95% CI: 1.04-1.11), nitrogen dioxide (NO2) (aOR: 1.13, 95% CI: 1.07-1.21) and sulfur dioxide (SO2) (aOR: 1.26, 95% CI: 1.16-1.35). However, no positive association was observed between ozone exposure and stillbirth. In the two-pollutant models, PM2.5 and CO exposures were found to be consistently associated with stillbirth. CONCLUSIONS: Our study revealed that exposure to high levels of PM2.5, PM10, SO2, NO2 and CO increases the risk of stillbirth and the most susceptible gestational period to ambient air pollution exposure was in the third trimester. Further toxicological and prospective cohort studies with improved exposure assessments are needed to confirm the causal link between air pollutants and stillbirth.
BACKGROUND: Recent studies suggest that ambient air pollution exposure during pregnancy is associated with stillbirth occurrence. However, the results on the associations between ambient air pollutants and stillbirths are inconsistent and little is known about the gestational timing of sensitive periods for the effects of ambient air pollutants exposure on stillbirth. OBJECTIVE: This study aimed to examine whether exposure to high levels of ambient air pollutants in a Chinese population is associated with an increased risk of stillbirth, and determine the gestational period when the fetus is most susceptible. METHODS: We conducted a population-based cohort study in Wuhan, China, involving 95,354 births between June 10, 2011 and June 9, 2013. The exposure assessments were based on the daily mean concentrations of air pollutants obtained from the exposure monitor nearest to the pregnant women's residence. Logistic regression analyses were performed to determine the associations between stillbirths and exposure to each of the air pollutants at different pregnancy periods with adjustment for confounding factors. RESULTS: Stillbirth increased with a 10 μg/m3 increase in particulate matter 2.5 (PM2.5) in each stage of pregnancy, and a significant association between carbon monoxide (CO) exposure and stillbirth was found during the third trimester (adjusted odds ratio (aOR): 1.01, 95% confidence interval (CI): 1.00-1.01) and in the entire pregnancy (aOR: 1.18, 95% CI: 1.04-1.34). Furthermore, an increased risk of stillbirth in the third trimester was associated with a 10 μg/m3 increase in PM10 (aOR: 1.08, 95% CI: 1.04-1.11), nitrogen dioxide (NO2) (aOR: 1.13, 95% CI: 1.07-1.21) and sulfur dioxide (SO2) (aOR: 1.26, 95% CI: 1.16-1.35). However, no positive association was observed between ozone exposure and stillbirth. In the two-pollutant models, PM2.5 and CO exposures were found to be consistently associated with stillbirth. CONCLUSIONS: Our study revealed that exposure to high levels of PM2.5, PM10, SO2, NO2 and CO increases the risk of stillbirth and the most susceptible gestational period to ambient air pollution exposure was in the third trimester. Further toxicological and prospective cohort studies with improved exposure assessments are needed to confirm the causal link between air pollutants and stillbirth.
Authors: Claire L Leiser; Heidi A Hanson; Kara Sawyer; Jacob Steenblik; Ragheed Al-Dulaimi; Troy Madsen; Karen Gibbins; James M Hotaling; Yetunde Oluseye Ibrahim; James A VanDerslice; Matthew Fuller Journal: Fertil Steril Date: 2018-12-05 Impact factor: 7.329
Authors: Alexandra Grippo; Jun Zhang; Li Chu; Yanjun Guo; Lihua Qiao; Jun Zhang; Ajay A Myneni; Lina Mu Journal: Rev Environ Health Date: 2018-09-25 Impact factor: 4.022
Authors: Miao Cai; Bin Zhang; Rong Yang; Tongzhang Zheng; Guanghui Dong; Hualiang Lin; Steven E Rigdon; Hong Xian; Leslie Hinyard; Pamela K Xaverius; Echu Liu; Thomas E Burroughs; Daire R Jansson; Morgan H LeBaige; Shaoping Yang; Zhengmin Qian Journal: BMC Pregnancy Childbirth Date: 2021-03-12 Impact factor: 3.007