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Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort
Kipruto Kirwa1, Zlatan Feric2, Justin Manjourides3
1Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
Insights
Prenatal exposure to fine particulate matter (PM2.5) was linked to a small but significant increase in preterm birth risk among ethnic minority women in Puerto Rico. This study highlights potential environmental health disparities in birth outcomes.
Area of Science:
- Environmental Health
- Reproductive Epidemiology
- Perinatal Studies
Background:
- Preterm birth (PTB) before 37 weeks of gestation is linked to adverse long-term health outcomes.
- Existing research on PTB and air pollution is inconsistent, particularly for minority populations.
- Understanding environmental risk factors for PTB in diverse populations is crucial.
Purpose of the Study:
- To investigate the association between prenatal exposure to fine particulate matter (PM2.5) and PTB risk.
- To examine potential modification of this association by phthalate exposure and sociodemographic factors.
- To provide insights into environmental health disparities in Puerto Rico.
Main Methods:
- Utilized data from the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) cohort.
- Assessed prenatal PM2.5 exposure using data from EPA monitors.
- Estimated prenatal phthalate exposure via urinary metabolite levels.
- Employed modified Poisson regression to analyze the PM2.5-PTB association.
Main Results:
- An interquartile range increase in PM2.5 exposure was associated with a 1.2% higher risk of PTB.
- No significant modification of the PM2.5-PTB association was observed based on infant sex, maternal age, income, or BMI.
- Phthalate metabolite levels did not alter the relationship between PM2.5 and PTB.
Conclusions:
- Prenatal PM2.5 exposure is associated with a small but significant increase in PTB risk among ethnic minority women in Puerto Rico.
- The findings suggest a potential environmental contribution to adverse birth outcomes in this population.
- Further research is needed to confirm these findings and explore intervention strategies.
Background:
Preterm birth (PTB, birth before 37 weeks of gestation) has been associated with adverse health outcomes across the lifespan. Evidence on the association between PTB and prenatal exposure to air pollutants is inconsistent, and is especially lacking for ethnic/racial minority populations.
Methods:
We obtained data on maternal characteristics and behaviors and PTB and other birth outcomes for women participating in the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) cohort, who lived in municipalities located along the North Coast of Puerto Rico. We assessed pre-natal PM2.5 exposures for each infant based on the nearest US Environmental Protection Agency monitor. We estimated prenatal phthalate exposures as the geometric mean of urinary measurements obtained during pregnancy. We then examined the association between PM2.5 and PTB using modified Poisson regression and assessed modification of the association by phthalate exposure levels and sociodemographic factors such as maternal age and infant gender.
Results:
Among 1092 singleton births, 9.1% of infants were born preterm and 92.9% of mothers had at least a high school education. Mothers had a mean (standard deviation) age of 26.9 (5.5) years and a median (range) of 2.0 (1.0-8.0) pregnancies. Nearly all women were Hispanic white, black, or mixed race. Median (range) prenatal PM2.5 concentrations were 6.0 (3.1-19.8) μ g/m3. Median (interquartile range) prenatal phthalate levels were 14.9 (8.9-26.0) and 14.5 (8.4-26.0), respectively, for di-n-butyl phthalate (DBP) and di-isobutyl phthalate (DiBP). An interquartile range increase in PM2.5 was associated with a 1.2% (95% CI 0.4, 2.1%) higher risk of PTB. There was little difference in PTB risk in strata of infant sex, mother's age, family income, history of adverse birth outcome, parity, and pre-pregnancy body mass index. Pregnancy urinary phthalate metabolite levels did not modify the PM2.5-PTB association.
Conclusion:
Among ethnic minority women in Puerto Rico, prenatal PM2.5 exposure is associated with a small but significant increase in risk of PTB.
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