Short-term effects of air pollution exposure on the risk of preterm birth in Xi'an, China

Liren Yang; Guilan Xie; Wenfang Yang; Ruiqi Wang; Boxing Zhang; Mengmeng Xu; Landi Sun; Xu Xu; Wanwan Xiang; Xiaoyi Cui; Yiwen Luo; Mei Chun Chung

doi:10.1080/07853890.2022.2163282

Short-term effects of air pollution exposure on the risk of preterm birth in Xi'an, China

Ann Med. 2023 Dec;55(1):325-334. doi: 10.1080/07853890.2022.2163282.

Authors

Liren Yang^{1

2}, Guilan Xie^{1

2}, Wenfang Yang¹, Ruiqi Wang^{1

2}, Boxing Zhang^{1

2}, Mengmeng Xu¹, Landi Sun^{1

2}, Xu Xu³, Wanwan Xiang^{1

4}, Xiaoyi Cui^{1

5}, Yiwen Luo^{1

2}, Mei Chun Chung⁶

Affiliations

¹ Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China.
² School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China.
³ The National Medical Center Office, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China.
⁴ College of Public Health, Zhengzhou University, Zhengzhou, P.R. China.
⁵ College of Nursing, Peking University Health Science Center, Beijing, P.R. China.
⁶ Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.

Abstract

Introduction: Long-term exposure to air pollution is known to be harmful to preterm birth (PTB), but little is known about the short-term effects. This study aims to quantify the short-term effect of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM_2.5), ≤10 μm (PM₁₀) and nitrogen dioxide (NO₂) on PTB.

Materials and methods: A total of 18,826 singleton PTBs were collected during the study period. Poisson regression model combined with the distributed lag non-linear model was applied to evaluate the short-term effects of PTBs and air pollutants.

Results: Maternal exposure to NO₂ was significantly associated increased risk of PTB at Lag1 (RR: 1.025, 95%CI: 1.003-1.047). In the moving average model, maternal exposure to NO₂ significantly increased the risk of PTB at Lag01 (RR: 1.029, 95%CI: 1.004-1.054). In the cumulative model, maternal exposure to NO₂ significant increased the risk of PTB at Cum01 (RR:1.026, 95%CI: 1.002-1.051), Cum02 (RR: 1.030, 95%CI: 1.003-1.059), and Cum03 (RR: 1.033, 95%CI: 1.002-1.066). The effects of PM_2.5, PM₁₀ and NO₂ on PTB were significant and greater in the cold season than the warm season.

Conclusions: Maternal exposure to NO₂, PM_2.5 and PM₁₀ before delivery has a significant risk for PTB, particularly in the cold season.Key messagesMaternal exposure to NO₂ was significant associated with an increased risk of preterm birth at the day 1 before delivery.Particle matter (PM_2.5 and PM₁₀) showed a significant short-term effect on preterm birth in the cold season.The effects of air pollutants on preterm birth was greater in the cold season compared with the warm season.

Keywords: Air pollution; preterm birth; short-term; time series.

Publication types

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

MeSH terms

Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
China / epidemiology
Female
Humans
Infant, Newborn
Nitrogen Dioxide / adverse effects
Nitrogen Dioxide / analysis
Particulate Matter / adverse effects
Particulate Matter / analysis
Premature Birth* / epidemiology
Premature Birth* / etiology

Substances

Nitrogen Dioxide
Air Pollutants
Particulate Matter

Grants and funding

The present study was supported by National Social Science Foundation of China under grant numbers [20BRK037], the Key Research and Development Program of Shaanxi under grant numbers [2019SF-100]; the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University, China under grant numbers [XJTU1AF-CRF-2019-023]. The funders did not participate in any part of the study form design to approval of the manuscript, except for supporting this project.