Global, regional, and national burden of preterm birth attributable to ambient and household PM2.5 from 1990 to 2019: Worsening or improving?

Xiao-Xuan Liu; Shu-Jun Fan; Ya-Na Luo; Li-Xin Hu; Cong-Cong Li; Yi-Dan Zhang; Jia-Xin Li; Hui-Ling Qiu; Guang-Hui Dong; Bo-Yi Yang

doi:10.1016/j.scitotenv.2023.161975

Global, regional, and national burden of preterm birth attributable to ambient and household PM_2.5 from 1990 to 2019: Worsening or improving?

Sci Total Environ. 2023 May 1:871:161975. doi: 10.1016/j.scitotenv.2023.161975. Epub 2023 Feb 3.

Authors

Affiliations

¹ Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
² Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
³ Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China. Electronic address: donggh5@mail.sysu.edu.cn.
⁴ Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China. Electronic address: yangby23@mail.sysu.edu.cn.

PMID: 36740066
DOI: 10.1016/j.scitotenv.2023.161975

Abstract

Background: Maternal exposure to fine particular matter (PM_2.5) during pregnancy, including ambient and household PM_2.5, has been linked with increased risk of preterm birth (PTB). However, the global spatio-temporal distribution of PTB-related deaths and disability-adjusted life years (DALYs) attributable to PM_2.5 is not well documented. We estimated the global, regional, and national patterns and trends of PTB burden attributable to both ambient and household PM_2.5 from 1990 to 2019.

Methods: Based on the Global Burden of Disease Study (GBD) 2019 database, we obtained the numbers of deaths and DALYs as well as age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of PTB attributable to total, ambient, and household PM_2.5 by socio-demographic index (SDI) and sex during 1990-2019. The average annual percentage changes (AAPCs) were calculated to assess the temporal trends of attributable burdens.

Results: In 2019, 126,752 deaths and 11.3 million DALYs related to PTB worldwide (two-thirds in Western Sub-Saharan Africa and South Asia) could be caused by excess PM_2.5 above the theoretical minimum-risk exposure level (TMREL), of which 39 % and 61 % were attributable to ambient PM_2.5 and household PM_2.5, respectively. From 1990 to 2019, the global ASMR due to ambient PM_2.5 increased slightly by 7.08 % whereas that due to household PM_2.5 decreased substantially by 58.81 %, although the latter still dominated the attributable PTB burden, especially in low and low-middle SDI regions. Similar results were also observed for ASDRs. In addition, PTB burden due to PM_2.5 was higher in male infants and in lower SDI regions.

Conclusions: Globally in 2019, PM_2.5 remains a great concern on the PTB burden, especially in Western Sub-Saharan Africa and South Asia. Between 1990 and 2019, age-standardized burden of PTB due to ambient PM_2.5 increased globally, while that due to household PM_2.5 decreased markedly but still dominated in low and low-middle SDI regions.

Keywords: Disease burden; Fine particular matter (PM(2.5)); Household air pollution; Preterm birth.

Published by Elsevier B.V.

MeSH terms

Asia, Southern
Female
Global Burden of Disease
Humans
Infant
Infant, Newborn
Male
Particulate Matter / toxicity
Premature Birth* / chemically induced
Premature Birth* / epidemiology
Quality-Adjusted Life Years

Substances

Particulate Matter