Zhijiang Liang1, Yin Yang2, Zhengmin Qian3, Zengliang Ruan2, Jenjen Chang3, Michael G Vaughn4, Qingguo Zhao5, Hualiang Lin6. 1. Department of Public Health, Guangdong Women and Children Hospital, 521 Xingnan Road, Panyu District, Guangzhou 511442, China. 2. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China. 3. Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, United States of America. 4. School of Social Work, College for Public Health & Social Justice, Saint Louis University, St. Louis. MO 63103, United States of America. 5. Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics, Family Planning Research Institute of Guangdong Province, Guangzhou, China; Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics (National Health and Family Planning Commission), Family Planning Special Hospital of Guangdong Province, Guangzhou, China. Electronic address: zqgfrost@126.com. 6. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China. Electronic address: linhualiang@mail.sysu.edu.cn.
Abstract
BACKGROUND: Previous studies have reported that maternal exposure to particles with aerodynamic diameter <2.5 μm (PM2.5) is associated with birth outcomes. However, a multicity birth cohort study has not been conducted in China, and the attributable fraction of adverse birth outcomes due to PM2.5 exposure remains unknown. METHODS: We examined associations in a birth cohort of 1,455,026 mother-and-live-birth pairs who were followed up from the first hospital visit for pregnancy until the birth of the baby during 2014-2017 in nine cites of the Pearl River Delta (PRD) region, China. The PM2.5 exposures were estimated based on the air pollution concentrations of the nearby monitors. Cox proportional hazards regressions were employed to examine the associations. RESULTS: We found 1% (HR = 1.01; 95% CI: 1.00, 1.02), 6% (HR = 1.06; 95% CI: 1.05, 1.07), and 7% (HR = 1.07; 95% CI: 1.06, 1.08) increases in risk of PTB and 20% (HR = 1.20; 95% CI: 1.18, 1.22), 18% (HR = 1.18; 95% CI: 1.15, 1.20), and 20% (HR = 1.20; 95% CI: 1.17, 1.23) increases in risk of LBW, with each 10 μg/m3 increase in PM2.5 from trimester 1 to trimester 3, respectively. For PTB, highest HRs were observed during trimester 3, as for LBW, stronger effect were observed during trimester 1 and trimester 3. We further estimated that 7.84% (95% CI: 6.21%, 9.50%) of PTB and 14.85% (95% CI: 13.00%, 16.61%) of the LBW cases could be attributable to PM2.5 exposure during the third trimester. CONCLUSION: The results indicate that maternal PM2.5 exposure is a risk factor for both LBW and PTB, and responsible for considerable burdens of PTB and LBW in the Pearl River Delta region.
BACKGROUND: Previous studies have reported that maternal exposure to particles with aerodynamic diameter <2.5 μm (PM2.5) is associated with birth outcomes. However, a multicity birth cohort study has not been conducted in China, and the attributable fraction of adverse birth outcomes due to PM2.5 exposure remains unknown. METHODS: We examined associations in a birth cohort of 1,455,026 mother-and-live-birth pairs who were followed up from the first hospital visit for pregnancy until the birth of the baby during 2014-2017 in nine cites of the Pearl River Delta (PRD) region, China. The PM2.5 exposures were estimated based on the air pollution concentrations of the nearby monitors. Cox proportional hazards regressions were employed to examine the associations. RESULTS: We found 1% (HR = 1.01; 95% CI: 1.00, 1.02), 6% (HR = 1.06; 95% CI: 1.05, 1.07), and 7% (HR = 1.07; 95% CI: 1.06, 1.08) increases in risk of PTB and 20% (HR = 1.20; 95% CI: 1.18, 1.22), 18% (HR = 1.18; 95% CI: 1.15, 1.20), and 20% (HR = 1.20; 95% CI: 1.17, 1.23) increases in risk of LBW, with each 10 μg/m3 increase in PM2.5 from trimester 1 to trimester 3, respectively. For PTB, highest HRs were observed during trimester 3, as for LBW, stronger effect were observed during trimester 1 and trimester 3. We further estimated that 7.84% (95% CI: 6.21%, 9.50%) of PTB and 14.85% (95% CI: 13.00%, 16.61%) of the LBW cases could be attributable to PM2.5 exposure during the third trimester. CONCLUSION: The results indicate that maternal PM2.5 exposure is a risk factor for both LBW and PTB, and responsible for considerable burdens of PTB and LBW in the Pearl River Delta region.
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