Ambient air pollution and preterm birth: A prospective birth cohort study in Wuhan, China

Zhengmin Qian, Shengwen Liang, Shaoping Yang, Edwin Trevathan, Zhen Huang, Rong Yang, Jing Wang, Ke Hu, Yiming Zhang, Michael Vaughn, Longjiao Shen, Wenjin Liu, Pu Li, Patrick Ward, Li Yang, Wei Zhang, Wei Chen, Guanghui Dong, Tongzhang Zheng, Shunqing XuBin Zhang

Research output: Contribution to journalArticle

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Abstract

Importance: Although studies in western countries suggest that ambient air pollution is positively associated with adverse pregnancy outcomes, the upper levels of pollutant exposures have been relatively low, thus eroding confidence in the conclusions. Meanwhile, in Asia, where upper levels of exposure have been greater, there have been limited studies of the association between air pollution and adverse pregnancy outcomes. Objective: The primary objective was to evaluate whether high levels of pollution, including particulate matter pollution with a mass median aerodynamic diameter of less than 2.5 μm (PM2.5) and 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) are related to increased occurrence of preterm birth (PTB). Methods: We conducted a population-based study in Wuhan, China in a cohort of 95,911 live births during a two-year period from 2011 to 2013. The exposure was estimated based on daily mean concentrations of pollutants estimated using the pollutants' measurements from the nine closest monitors. Logistic regressions were performed to determine the relationships between exposure to each of the pollutants during different pregnancy periods and PTB while controlling for key covariates. Results: We found 3% (OR = 1.03; 95% CI: 1.02, 1.05), 2% (OR = 1.02; 95% CI: 1.02, 1.03), 15% (OR = 1.15; 95% CI: 1.11, 1.19), and 5% (OR = 1.05; 95% CI: 1.02, 1.07) increases in risk of PTB with each 5-μg/m3 increase in PM2.5 and PM10 concentrations, 100-μg/m3 increase in CO concentrations, and 10-μg/m3 increase in O3 concentrations, respectively. There was negligible evidence for associations for SO2 and NO2. The effects from two-pollutant models were similar to the estimated effects from single pollutant models. No critical exposure windows were identified consistently: the strongest effect for PTB was found in the second trimester for PM2.5, PM10, and CO, but for SO2 it was in the first trimester, second month, and third month. For NO2 it was in the first trimester and second month, and for O3, the third trimester. Conclusion: Findings reveal an association between air pollutants and PTB. However, more toxicological studies and prospective cohort studies with improved exposure assessments are needed to establish causality related to specific pollutants.

Original languageEnglish (US)
Pages (from-to)195-203
Number of pages9
JournalInternational Journal of Hygiene and Environmental Health
Volume219
Issue number2
DOIs
StatePublished - Mar 1 2016

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Premature Birth
Air Pollution
China
Cohort Studies
Parturition
Carbon Monoxide
First Pregnancy Trimester
Pregnancy Outcome
Nitrogen Dioxide
Sulfur Dioxide
Air Pollutants
Particulate Matter
Ozone
Third Pregnancy Trimester
Live Birth
Second Pregnancy Trimester
Causality
Toxicology
Logistic Models
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Qian, Zhengmin ; Liang, Shengwen ; Yang, Shaoping ; Trevathan, Edwin ; Huang, Zhen ; Yang, Rong ; Wang, Jing ; Hu, Ke ; Zhang, Yiming ; Vaughn, Michael ; Shen, Longjiao ; Liu, Wenjin ; Li, Pu ; Ward, Patrick ; Yang, Li ; Zhang, Wei ; Chen, Wei ; Dong, Guanghui ; Zheng, Tongzhang ; Xu, Shunqing ; Zhang, Bin. / Ambient air pollution and preterm birth : A prospective birth cohort study in Wuhan, China. In: International Journal of Hygiene and Environmental Health. 2016 ; Vol. 219, No. 2. pp. 195-203.
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abstract = "Importance: Although studies in western countries suggest that ambient air pollution is positively associated with adverse pregnancy outcomes, the upper levels of pollutant exposures have been relatively low, thus eroding confidence in the conclusions. Meanwhile, in Asia, where upper levels of exposure have been greater, there have been limited studies of the association between air pollution and adverse pregnancy outcomes. Objective: The primary objective was to evaluate whether high levels of pollution, including particulate matter pollution with a mass median aerodynamic diameter of less than 2.5 μm (PM2.5) and 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) are related to increased occurrence of preterm birth (PTB). Methods: We conducted a population-based study in Wuhan, China in a cohort of 95,911 live births during a two-year period from 2011 to 2013. The exposure was estimated based on daily mean concentrations of pollutants estimated using the pollutants' measurements from the nine closest monitors. Logistic regressions were performed to determine the relationships between exposure to each of the pollutants during different pregnancy periods and PTB while controlling for key covariates. Results: We found 3{\%} (OR = 1.03; 95{\%} CI: 1.02, 1.05), 2{\%} (OR = 1.02; 95{\%} CI: 1.02, 1.03), 15{\%} (OR = 1.15; 95{\%} CI: 1.11, 1.19), and 5{\%} (OR = 1.05; 95{\%} CI: 1.02, 1.07) increases in risk of PTB with each 5-μg/m3 increase in PM2.5 and PM10 concentrations, 100-μg/m3 increase in CO concentrations, and 10-μg/m3 increase in O3 concentrations, respectively. There was negligible evidence for associations for SO2 and NO2. The effects from two-pollutant models were similar to the estimated effects from single pollutant models. No critical exposure windows were identified consistently: the strongest effect for PTB was found in the second trimester for PM2.5, PM10, and CO, but for SO2 it was in the first trimester, second month, and third month. For NO2 it was in the first trimester and second month, and for O3, the third trimester. Conclusion: Findings reveal an association between air pollutants and PTB. However, more toxicological studies and prospective cohort studies with improved exposure assessments are needed to establish causality related to specific pollutants.",
author = "Zhengmin Qian and Shengwen Liang and Shaoping Yang and Edwin Trevathan and Zhen Huang and Rong Yang and Jing Wang and Ke Hu and Yiming Zhang and Michael Vaughn and Longjiao Shen and Wenjin Liu and Pu Li and Patrick Ward and Li Yang and Wei Zhang and Wei Chen and Guanghui Dong and Tongzhang Zheng and Shunqing Xu and Bin Zhang",
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Qian, Z, Liang, S, Yang, S, Trevathan, E, Huang, Z, Yang, R, Wang, J, Hu, K, Zhang, Y, Vaughn, M, Shen, L, Liu, W, Li, P, Ward, P, Yang, L, Zhang, W, Chen, W, Dong, G, Zheng, T, Xu, S & Zhang, B 2016, 'Ambient air pollution and preterm birth: A prospective birth cohort study in Wuhan, China', International Journal of Hygiene and Environmental Health, vol. 219, no. 2, pp. 195-203. https://doi.org/10.1016/j.ijheh.2015.11.003

Ambient air pollution and preterm birth : A prospective birth cohort study in Wuhan, China. / Qian, Zhengmin; Liang, Shengwen; Yang, Shaoping; Trevathan, Edwin; Huang, Zhen; Yang, Rong; Wang, Jing; Hu, Ke; Zhang, Yiming; Vaughn, Michael; Shen, Longjiao; Liu, Wenjin; Li, Pu; Ward, Patrick; Yang, Li; Zhang, Wei; Chen, Wei; Dong, Guanghui; Zheng, Tongzhang; Xu, Shunqing; Zhang, Bin.

In: International Journal of Hygiene and Environmental Health, Vol. 219, No. 2, 01.03.2016, p. 195-203.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ambient air pollution and preterm birth

T2 - A prospective birth cohort study in Wuhan, China

AU - Qian, Zhengmin

AU - Liang, Shengwen

AU - Yang, Shaoping

AU - Trevathan, Edwin

AU - Huang, Zhen

AU - Yang, Rong

AU - Wang, Jing

AU - Hu, Ke

AU - Zhang, Yiming

AU - Vaughn, Michael

AU - Shen, Longjiao

AU - Liu, Wenjin

AU - Li, Pu

AU - Ward, Patrick

AU - Yang, Li

AU - Zhang, Wei

AU - Chen, Wei

AU - Dong, Guanghui

AU - Zheng, Tongzhang

AU - Xu, Shunqing

AU - Zhang, Bin

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Importance: Although studies in western countries suggest that ambient air pollution is positively associated with adverse pregnancy outcomes, the upper levels of pollutant exposures have been relatively low, thus eroding confidence in the conclusions. Meanwhile, in Asia, where upper levels of exposure have been greater, there have been limited studies of the association between air pollution and adverse pregnancy outcomes. Objective: The primary objective was to evaluate whether high levels of pollution, including particulate matter pollution with a mass median aerodynamic diameter of less than 2.5 μm (PM2.5) and 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) are related to increased occurrence of preterm birth (PTB). Methods: We conducted a population-based study in Wuhan, China in a cohort of 95,911 live births during a two-year period from 2011 to 2013. The exposure was estimated based on daily mean concentrations of pollutants estimated using the pollutants' measurements from the nine closest monitors. Logistic regressions were performed to determine the relationships between exposure to each of the pollutants during different pregnancy periods and PTB while controlling for key covariates. Results: We found 3% (OR = 1.03; 95% CI: 1.02, 1.05), 2% (OR = 1.02; 95% CI: 1.02, 1.03), 15% (OR = 1.15; 95% CI: 1.11, 1.19), and 5% (OR = 1.05; 95% CI: 1.02, 1.07) increases in risk of PTB with each 5-μg/m3 increase in PM2.5 and PM10 concentrations, 100-μg/m3 increase in CO concentrations, and 10-μg/m3 increase in O3 concentrations, respectively. There was negligible evidence for associations for SO2 and NO2. The effects from two-pollutant models were similar to the estimated effects from single pollutant models. No critical exposure windows were identified consistently: the strongest effect for PTB was found in the second trimester for PM2.5, PM10, and CO, but for SO2 it was in the first trimester, second month, and third month. For NO2 it was in the first trimester and second month, and for O3, the third trimester. Conclusion: Findings reveal an association between air pollutants and PTB. However, more toxicological studies and prospective cohort studies with improved exposure assessments are needed to establish causality related to specific pollutants.

AB - Importance: Although studies in western countries suggest that ambient air pollution is positively associated with adverse pregnancy outcomes, the upper levels of pollutant exposures have been relatively low, thus eroding confidence in the conclusions. Meanwhile, in Asia, where upper levels of exposure have been greater, there have been limited studies of the association between air pollution and adverse pregnancy outcomes. Objective: The primary objective was to evaluate whether high levels of pollution, including particulate matter pollution with a mass median aerodynamic diameter of less than 2.5 μm (PM2.5) and 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO) are related to increased occurrence of preterm birth (PTB). Methods: We conducted a population-based study in Wuhan, China in a cohort of 95,911 live births during a two-year period from 2011 to 2013. The exposure was estimated based on daily mean concentrations of pollutants estimated using the pollutants' measurements from the nine closest monitors. Logistic regressions were performed to determine the relationships between exposure to each of the pollutants during different pregnancy periods and PTB while controlling for key covariates. Results: We found 3% (OR = 1.03; 95% CI: 1.02, 1.05), 2% (OR = 1.02; 95% CI: 1.02, 1.03), 15% (OR = 1.15; 95% CI: 1.11, 1.19), and 5% (OR = 1.05; 95% CI: 1.02, 1.07) increases in risk of PTB with each 5-μg/m3 increase in PM2.5 and PM10 concentrations, 100-μg/m3 increase in CO concentrations, and 10-μg/m3 increase in O3 concentrations, respectively. There was negligible evidence for associations for SO2 and NO2. The effects from two-pollutant models were similar to the estimated effects from single pollutant models. No critical exposure windows were identified consistently: the strongest effect for PTB was found in the second trimester for PM2.5, PM10, and CO, but for SO2 it was in the first trimester, second month, and third month. For NO2 it was in the first trimester and second month, and for O3, the third trimester. Conclusion: Findings reveal an association between air pollutants and PTB. However, more toxicological studies and prospective cohort studies with improved exposure assessments are needed to establish causality related to specific pollutants.

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