Nitrogen dioxide air pollution and preterm birth in Shanghai, China

Xinhua Ji; Xia Meng; Cong Liu; Renjie Chen; Yihui Ge; Lena Kan; Qingyan Fu; Weihua Li; Lap Ah Tse; Haidong Kan

doi:10.1016/j.envres.2018.11.007

Nitrogen dioxide air pollution and preterm birth in Shanghai, China

Environ Res. 2019 Feb:169:79-85. doi: 10.1016/j.envres.2018.11.007. Epub 2018 Nov 3.

Authors

Xinhua Ji¹, Xia Meng², Cong Liu³, Renjie Chen⁴, Yihui Ge³, Lena Kan⁵, Qingyan Fu⁶, Weihua Li⁷, Lap Ah Tse⁸, Haidong Kan⁹

Affiliations

¹ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; International Peace Maternity and Child Health Hospital of China Welfare Institute, Shanghai, China.
² Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
³ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
⁴ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Key Laboratory of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproduction and Development, Fudan University, Shanghai, China.
⁵ School of Public Health, University of California, Berkeley, CA, USA.
⁶ Shanghai Environmental Monitoring Center, Shanghai, China.
⁷ Key Laboratory of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproduction and Development, Fudan University, Shanghai, China.
⁸ JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR.
⁹ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Key Laboratory of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproduction and Development, Fudan University, Shanghai, China. Electronic address: kanh@fudan.edu.cn.

PMID: 30423521
DOI: 10.1016/j.envres.2018.11.007

Abstract

Background: Nitrogen dioxide (NO₂) is a typical indicator of traffic-related air pollution, and few studies with exposure assessment of high resolution have been conducted to explore its association with preterm birth in China.

Objectives: To investigate the association between NO₂ exposure based on a land use regression (LUR) model and preterm birth in Shanghai, China.

Methods: A retrospective cohort study was performed among 25,493 singleton pregnancies in a major maternity hospital in Shanghai, China, from 2014 to 2015. A temporally adjusted LUR model was used to predict the prenatal exposure to NO₂ based on residence address of each gravida. Logistic regression was performed to evaluate the associations of ambient NO₂ exposure with preterm birth during six exposure periods, including the entire pregnancy, the first trimester, the second trimester, the third trimester, the last month, and the last week before delivery. Sensitivity analysis with a matched case-control design was conducted to test the robustness of the association between NO₂ exposure and preterm birth.

Results: The average NO₂ concentrations during the entire pregnancy was 48.23 µg/m³ among all participants. A 10 µg/m³ increase in NO₂ concentrations was associated with preterm birth, with an adjusted odds ratio of 1.03 (95% confidence interval [CI]: 0.96,1.10) for exposures during the entire pregnancy, 1.00 (95%CI: 0.95,1.06) in the first trimester, 1.01 (95%CI: 0.96,1.07) in the second trimester, 1.07 (95%CI: 1.02,1.13) in the third trimester, 1.10 (95%CI: 1.04,1.15) and 1.05 (95%CI: 1.00,1.09) in the month and week before delivery, respectively. The results of the matched case-control analysis were generally consistent with those of main analyses.

Conclusion: NO₂ may increase the risk of preterm birth, especially for exposures during the third trimester, the month and the week before delivery in Shanghai, China.

Keywords: Air pollution; Land use regression model; Nitrogen dioxide; Preterm birth.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants*
Air Pollution / statistics & numerical data*
China / epidemiology
Female
Humans
Infant, Newborn
Maternal Exposure / statistics & numerical data*
Nitrogen Dioxide / analysis*
Particulate Matter
Pregnancy
Premature Birth / epidemiology*
Retrospective Studies

Substances

Air Pollutants
Particulate Matter
Nitrogen Dioxide