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Updated: Nov 16, 2025

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Differences in environmental factors contributing to preterm labor and PPROM - Population based study.

Roni Gat1, Eric Kachko2, Itai Kloog3

  • 1Negev Environmental Health Research Institute, Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel; Department of Geography and Environmental Development, Ben-Gurion University, Beer Sheva, Israel.

Environmental Research
|February 20, 2021
PubMed
Summary

High temperatures increase the risk of preterm prelabor rupture of membranes (PPROM) in Bedouin-Arab women. Ambient pollution is linked to spontaneous preterm labor (PTL) in Jewish women, indicating distinct environmental risks for preterm birth precursors.

Keywords:
Air pollution (AP)Air temperature (Ta)Indicated preterm deliveryParticulate matter (PM)Prelabor rupture of membranes (PROM)Preterm laborSpontaneous preterm birth (PTB)

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Area of Science:

  • Environmental Health
  • Obstetrics
  • Epidemiology

Background:

  • Previous studies suggest a link between ambient temperature (Ta), air pollution, and preterm birth (PTB).
  • Limited information exists on how environmental factors specifically influence precursors of spontaneous preterm birth, such as preterm labor (PTL) and preterm prelabor rupture of membranes (PPROM).

Purpose of the Study:

  • To investigate the association between ambient temperature (Ta) and air pollution during gestation and the precursors of spontaneous preterm parturition (PTL and PPROM).

Main Methods:

  • Analysis of 84,476 deliveries from 2003-2013, including daily measurements of Ta, PM2.5, and PM10.
  • Exposure assessment in windows of one week and two days prior to delivery admission.
  • Poisson regression models adjusted for gestational age and socio-economic status.

Main Results:

  • PPROM showed higher sensitivity to Ta fluctuations compared to PTL.
  • Bedouin-Arab ethnicity was associated with elevated Ta, increasing PPROM risk (RR=1.19).
  • Jewish ethnicity showed susceptibility to ambient pollutants preceding PTL (RR=1.025 for 2 days, RR=1.017 for 1 day).

Conclusions:

  • Elevated Ta is an independent risk factor for PPROM among Bedouin-Arabs.
  • Ambient pollution is an independent risk factor for spontaneous PTL in Jewish women.
  • The precursors of spontaneous preterm birth exhibit differing associations with specific environmental factors based on ethnicity.