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Maternal ambient air pollution exposure with spatial-temporal variations and preterm birth risk assessment during
Zhe Sun1, Liyang Yang2, Xiaoxia Bai3
1Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China; Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK.
Insights
Exposure to air pollution during pregnancy is linked to preterm birth (PTB). Sulfur dioxide (SO2) was the largest contributor, highlighting the need for pregnant mothers to avoid severe pollution, especially in the first and third trimesters.
Area of Science:
- Environmental Epidemiology
- Reproductive Health
- Public Health
Background:
- Preterm birth (PTB) is a major cause of neonatal morbidity and mortality.
- Previous studies often examined single air pollutants' effects on PTB.
- Limited research has explored the combined impacts of multiple air pollutants during pregnancy.
Purpose of the Study:
- To investigate the association between gestational exposure to various ambient air pollutants and PTB risk.
- To identify the most significant air pollutants contributing to PTB.
- To determine critical exposure windows during pregnancy for PTB risk.
Main Methods:
- A population-based environmental-epidemiology study of 6275 pregnant mothers in Zhejiang Province, China (2013-2017).
- Time-to-event logistic regressions adjusted for confounders.
- Quasi-AQI model and PCA-GLM analysis to address multi-pollutant collinearity.
Main Results:
- Gestational exposure to ambient air pollutants was significantly associated with PTB.
- Sulfur dioxide (SO2) was the largest single contributor (29.4%).
- Principal Component Analysis (PCA) identified key factors: prime factor (PM2.5, PM10, SO2, NO2) at 63.4%, carbon factor (CO) at 17.1%, and ozone factor (O3) at 19.5% contribution to PTB risk.
Conclusions:
- Ambient air pollution during pregnancy is a significant risk factor for preterm birth.
- The first and third trimesters represent the most sensitive periods for air pollution exposure.
- Pregnant mothers should minimize exposure to severe air pollution during these critical gestational windows.
Abstract:
Preterm birth (PTB) can give rise to significant neonatal morbidity and mortality, as well as children's long-term health defects. Many studies have illustrated the associations between ambient air pollution exposure during gestational periods and PTB risks, but most of them only focused on one single air pollutant, such as PM2.5. In this population-based environmental-epidemiology study, we recruited 6275 pregnant mothers in Zhejiang Province, China, and evaluated their gestational exposures to various air pollutants during 2013-2017. Time-to-event logistic regressions were performed to estimate risk associations after adjusting all confounders, and Quasi-AQI model and PCA-GLM analysis were applied to resolve the collinearity issues in multi-pollutant regression models. It was found that gestational exposure to ambient air pollutants was significantly associated with the occurrence of PTB, and SO2 was the largest contributor with a proportion of 29.4%. Three new variables, prime factor (a combination of PM2.5, PM10, SO2, and NO2), carbon factor (CO), and ozone factor (O3), were generated by PCA integration, contributing 63.4%, 17.1%, and 19.5% to PTB risks, respectively. The first and third trimester was the most crucial exposure window, suggesting the pregnant mothers better to avoid severe air pollution exposures during these sensitive periods.
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