Third trimester as the susceptibility window for maternal PM2.5 exposure and preterm birth: A nationwide surveillance-based association study in China

Zhimei Qiu; Wenyan Li; Yang Qiu; Zhiyu Chen; Fumo Yang; Wenli Xu; Yuyang Gao; Zhen Liu; Qi Li; Min Jiang; Hanmin Liu; Yu Zhan; Li Dai

doi:10.1016/j.scitotenv.2023.163274

Third trimester as the susceptibility window for maternal PM_2.5 exposure and preterm birth: A nationwide surveillance-based association study in China

Sci Total Environ. 2023 Jul 1:880:163274. doi: 10.1016/j.scitotenv.2023.163274. Epub 2023 Apr 4.

Authors

Zhimei Qiu¹, Wenyan Li², Yang Qiu³, Zhiyu Chen², Fumo Yang⁴, Wenli Xu², Yuyang Gao², Zhen Liu², Qi Li², Min Jiang⁵, Hanmin Liu⁶, Yu Zhan⁴, Li Dai⁷

Affiliations

¹ Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan 610065, China; The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
² National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China.
³ Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan 610065, China.
⁴ Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan 610065, China; College of Carbon Neutrality Future Technology, Sichuan University, Chengdu, Sichuan 610065, China.
⁵ Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China.
⁶ Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China; NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu 610041, Sichuan, China.
⁷ The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, China. Electronic address: daili@scu.edu.cn.

PMID: 37019233
DOI: 10.1016/j.scitotenv.2023.163274

Abstract

Maternal PM_2.5 exposure has been identified as a potential risk factor for preterm birth, yet the inconsistent findings on the susceptible exposure windows may be partially due to the influence of gaseous pollutants. This study aims to examine the association between PM_2.5 exposure and preterm birth during different susceptible exposure windows after adjusting for exposure to gaseous pollutants. We collected 2,294,188 records of singleton live births from 30 provinces of China from 2013 to 2019, and the gridded daily concentrations of air pollutants (including PM_2.5, O₃, NO₂, SO₂, and CO) were derived by using machine learning models for assessing individual exposure. We employed logistic regression to develop single-pollutant models (including PM_2.5 only) and co-pollutant models (including PM_2.5 and a gaseous pollutant) to estimate the odds ratio for preterm birth and its subtypes, with adjustment for maternal age, neonatal sex, parity, meteorological conditions, and other potential confounders. In the single-pollutant models, PM_2.5 exposure in each trimester was significantly associated with preterm birth, and the third trimester exposure showed a stronger association with very preterm birth than that with moderate to late preterm birth. The co-pollutant models revealed that preterm birth might be significantly associated only with maternal exposure to PM_2.5 in the third trimester, and not with exposure in the first or second trimester. The observed significant associations between preterm birth and maternal PM_2.5 exposure in the first and second trimesters in single-pollutant models might primarily be influenced by exposure to gaseous pollutants. Our study provides evidence that the third trimester may be the susceptible window for maternal PM_2.5 exposure and preterm birth. The association between PM_2.5 exposure and preterm birth could be influenced by gaseous pollutants, which should be taken into consideration when evaluating the impact of PM_2.5 exposure on maternal and fetal health.

Keywords: Gaseous pollutants; Maternal PM(2.5) exposure; Preterm birth; Susceptible exposure window.

MeSH terms

Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution* / analysis
China / epidemiology
Female
Gases
Humans
Infant, Newborn
Maternal Exposure
Particulate Matter / adverse effects
Particulate Matter / analysis
Pregnancy
Pregnancy Trimester, Third
Premature Birth* / epidemiology

Substances

Particulate Matter
Air Pollutants
Gases