Prenatal particulate matter exposure and Intrauterine Fetal Death

Area of Science:

• Environmental Health
• Obstetrics and Gynecology
• Epidemiology

Background:

• Intrauterine Fetal Death (IUFD) is a critical pregnancy complication with largely unknown causes.
• Exposure to fine particulate matter (PM2.5) is a suspected risk factor for IUFD.

Purpose of the Study:

• To investigate the association between maternal PM2.5 exposure and IUFD risk.
• To examine ethnicity as a potential effect modifier.
• To identify critical prenatal periods for PM2.5 harm concerning IUFD.

Main Methods:

• Retrospective cohort study of 87,887 pregnancies (2003-2017) at Soroka University Medical Center.
• Residence-based PM2.5 exposure estimation using satellite data.
• Multivariable analysis stratified by ethnicity (Jewish, Bedouin-Arab), adjusting for confounders.

Main Results:

• A significant association was found between first-trimester and entire-pregnancy PM2.5 levels and increased IUFD risk exclusively among Jewish women.
• For every 10 μg/m³ increase in PM2.5, IUFD risk rose by 2.98 (95% CI 1.50-5.90) in the first trimester and 3.61 (95% CI 1.32-9.85) for the entire pregnancy.
• No significant association was observed for Bedouin-Arab women.

Conclusions:

• Maternal PM2.5 exposure is associated with increased IUFD risk, but this association appears specific to the Jewish ethnic group in this cohort.
• These findings underscore the necessity of considering ethnicity as a crucial effect modifier in air pollution and health studies.