Juan Chen1, Junkai Fang2, Ying Zhang3, Zhouyang Xu1, Hyang-Min Byun4, Peng-Hui Li5, Furong Deng1, Xinbiao Guo1, Liqiong Guo6, Shaowei Wu7. 1. Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China. 2. Tianjin Institute of Medical & Pharmaceutical Sciences, Tianjin, China. 3. Medical Genetic Laboratory, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China. 4. Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom. 5. School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin, China. 6. Institute of Disaster Medicine, Tianjin University, Tianjin, China. Electronic address: yingqidao@163.com. 7. Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China; Key Laboratory of Molecular Cardiovascular Sciences, Peking University, Ministry of Education, China. Electronic address: shaowei_wu@bjmu.edu.cn.
Abstract
BACKGROUND: Investigations on the potential effects of high air pollution exposure before pregnancy on adverse pregnancy outcomes are limited, and it is unknown whether air quality standards looser than that set by World Health Organization (WHO) still can provide sufficient protection pregnant women from adverse pregnancy outcomes. OBJECTIVES: To evaluate the potential effects of high ambient air pollution around pregnancy on preterm birth (PTB) and low birth weight (LBW), and assess the risk of PTB and LBW associated with air pollutants with reference to different air quality standards of WHO and China. METHODS: Our study leveraged 10,960 pregnant women from the Project ELEFANT. Daily average particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) and ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3) concentrations were collected based on Chinese Air Quality Reanalysis datasets. Hazard ratios (HR) of PTB and LBW were estimated for maternal PM2.5, PM10, NO2, SO2, CO and O3 exposures and related proportions of days with daily average air pollution concentrations exceeding air quality standards of WHO and China around pregnancy using Cox proportional hazards regression models with adjustment for potential confounders. RESULTS: Ambient PM2.5, PM10, NO2, SO2 and CO exposure during the before pregnancy and pregnancy period were both significantly and positively associated with increased risk of PTB, PTB subtypes and LBW. A 10% increase in proportion of days with daily average PM2.5 exceeding 25 μg/m3 over the entire pregnancy was most apparently associated with risk of PTB (HR, 12.66; 95% CI, 8.20-19.53) and LBW (HR, 17.42; 95% CI, 6.88-44.10) among all PM2.5 proportion variables based on different air quality standards. CONCLUSION: Air quality standards of WHO are necessary to be implemented to control for risks of adverse pregnancy outcomes associated with ambient air pollution in areas with high air pollution levels.
BACKGROUND: Investigations on the potential effects of high air pollution exposure before pregnancy on adverse pregnancy outcomes are limited, and it is unknown whether air quality standards looser than that set by World Health Organization (WHO) still can provide sufficient protection pregnant women from adverse pregnancy outcomes. OBJECTIVES: To evaluate the potential effects of high ambient air pollution around pregnancy on preterm birth (PTB) and low birth weight (LBW), and assess the risk of PTB and LBW associated with air pollutants with reference to different air quality standards of WHO and China. METHODS: Our study leveraged 10,960 pregnant women from the Project ELEFANT. Daily average particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) and ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3) concentrations were collected based on Chinese Air Quality Reanalysis datasets. Hazard ratios (HR) of PTB and LBW were estimated for maternal PM2.5, PM10, NO2, SO2, CO and O3 exposures and related proportions of days with daily average air pollution concentrations exceeding air quality standards of WHO and China around pregnancy using Cox proportional hazards regression models with adjustment for potential confounders. RESULTS: Ambient PM2.5, PM10, NO2, SO2 and CO exposure during the before pregnancy and pregnancy period were both significantly and positively associated with increased risk of PTB, PTB subtypes and LBW. A 10% increase in proportion of days with daily average PM2.5 exceeding 25 μg/m3 over the entire pregnancy was most apparently associated with risk of PTB (HR, 12.66; 95% CI, 8.20-19.53) and LBW (HR, 17.42; 95% CI, 6.88-44.10) among all PM2.5 proportion variables based on different air quality standards. CONCLUSION: Air quality standards of WHO are necessary to be implemented to control for risks of adverse pregnancy outcomes associated with ambient air pollution in areas with high air pollution levels.
Authors: Huan Li; Min Li; Shiyu Zhang; Zhengmin Min Qian; Zilong Zhang; Kai Zhang; Chongjian Wang; Lauren D Arnold; Stephen Edward McMillin; Shaowei Wu; Fei Tian; Hualiang Lin Journal: Sci Total Environ Date: 2022-01-04 Impact factor: 7.963