Temporal variation in air pollution concentrations and preterm birth-a population based epidemiological study

David Olsson, Magnus Ekström, Bertil Forsberg, David Olsson, Magnus Ekström, Bertil Forsberg

Abstract

There is growing evidence of adverse birth outcomes due to exposure to air pollution during gestation. However, recent negative studies are also reported. The aim of this study was to assess the effect of ozone and vehicle exhaust exposure (NO(2)) on the length of the gestational period and risk of preterm delivery. We used data from the Swedish Medical Birth Registry on all vaginally delivered singleton births in the Greater Stockholm area who were conceived during 1987-1995 (n = 115,588). Daily average levels of NO(2) (from three measuring stations) and ozone (two stations) were used to estimate trimester and last week of gestation average exposures. Linear regression models were used to assess the association between the two air pollutants and three exposure windows, while logistic regression models were used when analyzing associations with preterm delivery (<37 weeks gestation). Five percent were born preterm. The median gestational period was 40 weeks. Higher levels of ozone during the first trimester were associated with shorter gestation as well as with an elevated risk of preterm delivery, the odds ratio from the most complex model was 1.06 (95% CI: 1.00-1.13) per 10 μg/m(3) increase in the mean daily 8-h maximum concentration. Higher levels of ozone during the second trimester were associated with shorter gestation but the elevated risk of preterm delivery was not statistically significant. Higher levels of ozone and NO(2) during the last week of gestation were associated with a shorter duration of gestation and NO(2) also with preterm delivery. There were no significant associations between first and second trimester NO(2) exposure estimates and studied outcomes. The effect of first trimester ozone exposure, known to cause oxidative stress, was smallest among women who conceived during autumn when vitamin D status, important for fetal health, in Scandinavian women is the highest.

Keywords: nitrogen dioxide; ozone; pregnancy; preterm birth; vehicle emissions.

Figures

Figure 1
Figure 1
Histogram of duration of gestation.
Figure 2
Figure 2
Duration of gestation plotted against birth weight.

References

    1. Maisonet M., Correa A., Misra D., Jaakkola J.J.K. A review of the literature on the effects of ambient air pollution on fetal growth. Environ. Res. 2004;95:106–115.
    1. Srám R.J., Binková B., Dejmek J., Bobak M. Ambient air pollution and pregnancy outcomes: A review of the literature. Environ. Health Perspect. 2005;113:375–382.
    1. Ritz B., Wilhelm M., Hoggatt K.J., Ghosh J.K.C. Ambient air pollution and preterm birth in the environment and pregnancy outcomes study at the University of California, Los Angeles. Am. J. Epidemiol. 2007;166:1045–1052.
    1. Liu S., Krewski D., Shi Y., Chen Y., Burnett R.T. Association between gaseous ambient air pollutants and adverse pregnancy outcomes in Vancouver, Canada. Environ. Health Perspect. 2003;111:1773–1778.
    1. Ritz B., Yu F., Chapa G., Fruin S. Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology. 2000;11:502–511.
    1. Wilhelm M., Ritz B. Local variations in CO and particulate air pollution and adverse birth outcomes in Los Angeles County, California, USA. Environ. Health Perspect. 2005;113:1212–1221. doi: 10.1289/ehp.7751.
    1. Wu J., Ren C., Delfino R.J., Chung J., Wilhelm M., Ritz B. Association between local traffic-generated air pollution and preeclampsia and preterm delivery in the south coast air basin of California. Environ. Health Perspect. 2009;117:1773–1779.
    1. Landgren O. Environmental pollution and delivery outcome in Southern Sweden: A study with central registries. Acta Paediatr. 1996;85:1361–1364.
    1. Leem J.-H., Kaplan B.M., Shim Y.K., Pohl H.R., Gotway C.A., Bullard S.M., Rogers J.F., Smith M.M., Tylenda C.A. Exposures to air pollutants during pregnancy and preterm delivery. Environ. Health Perspect. 2006;114:905–910.
    1. Jalaludin B., Mannes T., Morgan G., Lincoln D., Sheppeard V., Corbett S. Impact of ambient air pollution on gestational age is modified by season in Sydney, Australia. Environ. Health. 2007;6
    1. Slama R., Darrow L., Parker J., Woodruff T.J., Strickland M., Nieuwenhuijsen M., Glinianaia S., Hoggatt K.J., Kannan S., Hurley F., et al. Meeting report: Atmospheric pollution and human reproduction. Environ. Health Perspect. 2008;116:791–798.
    1. Bobak M. Outdoor air pollution, low birth weight, and prematurity. Environ. Health Perspect. 2000;108:173–176. doi: 10.1289/ehp.00108173.
    1. Hansen C., Neller A., Williams G., Simpson R. Maternal exposure to low levels of ambient air pollution and preterm birth in Brisbane, Australia. BJOG. 2006;113:935–941.
    1. Bosetti C., Nieuwenhuijsen M.J., Gallus S., Cipriani S., La Vecchia C., Parazzini F. Ambient particulate matter and preterm birth or birth weight: A review of the literature. Arch. Toxicol. 2010;84:447–460.
    1. Gehring U., Wijga A.H., Fischer P., de Jongste J.C., Kerkhof M., Koppelman G.H., Smit H.A., Brunekreef B. Traffic-related air pollution, preterm birth and term birth weight in the PIAMA birth cohort study. Environ. Res. 2011;111:125–135.
    1. Llop S., Ballester F., Estarlich M., Esplugues A., Rebagliato M., Iniguez C. Preterm birth and exposure to air pollutants during pregnancy. Environ. Res. 2010;110:778–785.
    1. Kwinta P., Pietrzyk J.J. Preterm birth and respiratory disease in later life. Expert. Rev. Respir. Med. 2010;4:593–604.
    1. Skilton M.R., Viikari J.S., Juonala M., Laitinen T., Lehtimaki T., Taittonen L., Kahonen M., Celermajer D.S., Raitakari O.T. Fetal growth and preterm birth influence cardiovascular risk factors and arterial health in young adults: The cardiovascular risk in young Finns study. Arterioscler Thromb Vasc. Biol. 2011;31:2975–2981.
    1. Katsouyanni K., Schwartz J., Spix C., Touloumi G., Zmirou D., Zanobetti A., Wojtyniak B., Vonk J.M., Tobias A., Ponka A., et al. Short term effects of air pollution on health: A European approach using epidemiologic time series data: The APHEA protocol. J. Epidemiol. Community Health. 1996;50(Suppl 1):S12–S18. doi: 10.1136/jech.50.Suppl_1.S12.
    1. R Development Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; Vienna, Austria: 2011. [(accessed on 18 April 2011)]. Available online: .
    1. Andersson-Sköld Y., Janhäll S. Simulations of ozone formation from different emission sources in Sweden. Water Air Soil Pollut. 1995;85:2045–2050.
    1. Gryparis A., Forsberg B., Katsouyanni K., Analitis A., Touloumi G., Schwartz J., Samoli E., Medina S., Anderson H.R., Niciu E.M., et al. Acute effects of ozone on mortality from the “air pollution and health: A European approach” project. Am. J. Respir. Crit. Care Med. 2004;170:1080–1087. doi: 10.1164/rccm.200403-333OC.
    1. Cnattingius S., Ericson A., Gunnarskog J., Kallen B. A quality study of a medical birth registry. Scand. J. Soc. Med. 1990;18:143–148.
    1. Strickland M.J., Klein M., Darrow L.A., Flanders W.D., Correa A., Marcus M., Tolbert P.E. The issue of confounding in epidemiological studies of ambient air pollution and pregnancy outcomes. J. Epidemiol. Community Health. 2009;63:500–504.
    1. Shin J.S., Choi M.Y., Longtine M.S., Nelson D.M. Vitamin D effects on pregnancy and the placenta. Placenta. 2010;31:1027–1034.
    1. Catov J.M., Bodnar L.M., Ness R.B., Barron S.J., Roberts J.M. Inflammation and dyslipidemia related to risk of spontaneous preterm birth. Am. J. Epidemiol. 2007;166:1312–1319.
    1. Ngo D.T., Sverdlov A.L., McNeil J.J., Horowitz J.D. Does vitamin D modulate asymmetric dimethylarginine and C-reactive protein concentrations? Am. J. Med. 2010;123:335–341. doi: 10.1016/j.amjmed.2009.09.024.
    1. Lee P.C., Talbott E.O., Roberts J.M., Catov J.M., Sharma R.K., Ritz B. Particulate air pollution exposure and C-reactive protein during early pregnancy. Epidemiology. 2011;22:524–531.
    1. Moosgaard B., Vestergaard P., Heickendorff L., Melsen F., Christiansen P., Mosekilde L. Vitamin D status, seasonal variations, parathyroid adenoma weight and bone mineral density in primary hyperparathyroidism. Clin. Endocrinol. (Oxf.) 2005;63:506–513. doi: 10.1111/j.1365-2265.2005.02371.x.
    1. Donaldson K., Stone V., Seaton A., MacNee W. Ambient particle inhalation and the cardiovascular system: Potential mechanisms. Environ. Health Perspect. 2001;109(Suppl 4):523–527.
    1. Gitto E., Reiter R.J., Karbownik M., Tan D.-X., Gitto P., Barberi S., Barberi I. Causes of oxidative stress in the pre- and perinatal period. Biol. Neonate. 2002;81:146–157.
    1. Kannan S., Misra D.P., Dvonch J.T., Krishnakumar A. Exposures to airborne particulate matter and adverse perinatal outcomes: A biologically plausible mechanistic framework for exploring potential effect modification by nutrition. Environ. Health Perspect. 2006;114:1636–1642.

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