Windows of sensitivity for risk of adverse birth outcomes related to gestational PM2.5 exposure: Evidence from a natural experiment

Wei Ni; Yuhan Xing; Guoju Li; Zhanhui Du; Ping Yang; Qinzheng Wang; Xinmeng Yang; Bei Lyu; Hongge Fa; Qiuling Shi; Quansheng Xing

doi:10.1016/j.envpol.2024.123759

Windows of sensitivity for risk of adverse birth outcomes related to gestational PM_2.5 exposure: Evidence from a natural experiment

Environ Pollut. 2024 Apr 15:347:123759. doi: 10.1016/j.envpol.2024.123759. Epub 2024 Mar 8.

Authors

Wei Ni¹, Yuhan Xing², Guoju Li³, Zhanhui Du³, Ping Yang³, Qinzheng Wang³, Xinmeng Yang³, Bei Lyu³, Hongge Fa³, Qiuling Shi⁴, Quansheng Xing⁵

Affiliations

¹ Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China; State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
² Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, 518107, China.
³ Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China.
⁴ State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
⁵ Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China. Electronic address: xingqs0532@163.com.

PMID: 38462193
DOI: 10.1016/j.envpol.2024.123759

Abstract

While numerous studies have associated maternal exposure to PM_2.5 with adverse birth outcomes, findings remain inconsistent and difficult to generalize. We aimed to investigate the causal relationship and window of sensitivity between gestational exposure to PM_2.5 and birth outcomes. We leveraged high-resolution satellite data to quantify gestational PM_2.5 exposure at the individual level, along with a combined model to determine daily relative risks (RRs) of birth outcomes in COVID-19 prelockdown and lockdown groups. RRs between the two groups were further compared using a longitudinal pre-post non-experimental design to identify sensitivity windows of adverse birth outcomes. A total of 73,781 pregnant women from the COVID-19 prelockdown group and 6267 pregnant women from the lockdown group were included for analysis. The daily mean PM_2.5 concentrations in the lockdown group decreased by 21.7% compared to the prelockdown group. During the first trimester, every 10 μg/m³ increase in PM_2.5 significantly increased the risk of congenital abnormalities of major organs such as the cardiovascular system, gastrointestinal tract, nervous system, urinary system, and respiratory system. Moreover, gestational exposure to PM_2.5 during the first trimester was associated with higher risks of premature delivery and term low birth weight. While PM_2.5 exposure during the second trimester was positively correlated with macrosomia. Gestational exposure to PM_2.5 is associated with increased risks of various adverse birth outcomes with specific sensitive windows. We demonstrated that gestational exposure to PM_2.5 increased risks of various adverse birth outcomes with specific window of sensitivity through the natural experiment design. Our findings underscore the urgent need for policies and initiatives targeting PM_2.5 reduction, especially during critical periods of pregnancy.

Keywords: Adverse birth outcome; Congenital abnormality; Gestational PM(2.5) exposure; Satellite-retrieval; Window of sensitivity.

MeSH terms

Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
COVID-19* / epidemiology
Female
Humans
Infant, Low Birth Weight
Infant, Newborn
Maternal Exposure / adverse effects
Particulate Matter / analysis
Pregnancy
Premature Birth*

Substances

Air Pollutants
Particulate Matter