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Ambient fine particulate matter air pollution and the risk of preterm birth: A multicenter birth cohort study in
Chen Chu1, Yixiang Zhu2, Cong Liu2
1Heart Center, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
Insights
Exposure to fine particulate matter (PM2.5) during pregnancy, especially the first trimester, increases the risk of preterm birth (PTB). Reducing air pollution during pregnancy is crucial for preventing adverse birth outcomes.
Area of Science:
- Environmental Health
- Reproductive Epidemiology
- Public Health
Background:
- Preterm birth (PTB) before 37 weeks gestation has long-term health consequences for infants.
- Air pollution is a suspected risk factor for PTB, but evidence remains inconsistent.
- China faces significant air quality challenges, impacting maternal and child health.
Purpose of the Study:
- To investigate the association between fine particulate matter (PM2.5) exposure during pregnancy and PTB risk in China.
- To analyze PM2.5 exposure effects across different pregnancy trimesters.
- To identify vulnerable subgroups with potentially higher PTB risk due to PM2.5 exposure.
Main Methods:
- A multicenter birth cohort study involving 5976 live births in China (Jan. 2009 - Feb. 2011).
- Residential PM2.5 exposure was estimated using satellite remote sensing data.
- Cox proportional hazards regression models were used to assess the association between PM2.5 and PTB.
Main Results:
- A total of 443 (7.4%) PTBs were recorded.
- Pregnancy-wide PM2.5 exposure (HR=1.262) and first-trimester exposure (HR=1.114) were significantly associated with increased PTB risk.
- The association between PM2.5 and PTB was stronger in mothers with older age, lower pre-pregnancy BMI, and lower family income.
Conclusions:
- PM2.5 exposure during pregnancy, particularly the first trimester, is linked to a higher risk of preterm birth in China.
- Targeted air pollution reduction strategies during pregnancy, especially early on, are essential for mitigating PTB.
- Maternal age, BMI, and socioeconomic status may modify the impact of air pollution on PTB risk.
Abstract:
Preterm birth (PTB), defined as live birth before the 37th week of gestation, is believed to have profound impacts on the infant's health in later life. Air pollution has been suggested to be a potential risk factor of PTB, but the evidence was inconsistent. In this multicenter birth cohort study, we aimed to examine the association between fine particulate matter (PM2.5) exposure during pregnancy and PTB in China. A total of 5976 live births were identified between Jan. 2009 and Feb. 2011 from 8 provinces in China. Residential exposures to PM2.5 were assigned based on satellite remote sensing estimates. Cox proportional hazards regressions were employed to explore the correlation for each trimester as well as the entire pregnancy. A total of 443 (7.4%) preterm births were observed. The average PM2.5 during pregnancy was 57.2 ± 8.8 μg/m3. We found exposure to PM2.5 during the whole pregnancy (hazard ratio, HR = 1.262; 95% CI: 1.087-1.465) and in the first trimester (HR = 1.114; 95% CI: 1.007-1.232) was associated with higher risk of PTB. The associations of PM2.5 were stronger for subjects with older maternal or paternal age, lower maternal pre-pregnancy BMI, and lower family income. This study adds supports to the cumulating evidence linking PM2.5 exposure and elevated PTB risk. Measures of air pollution reduction are needed during pregnancy, especially at early stage of pregnancy to prevent adverse birth outcomes.
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