Ambient air pollution and the risk of stillbirth: a population-based prospective birth cohort study in the coastal area of China
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Accumulating evidence has shown that prenatal ambient air pollution exposure is associated with elevated stillbirth risk; however, the results are inconsistent. This population-based prospective cohort study aimed to explore the association between prenatal air pollution exposure and stillbirth rate in the coastal area in China. Data of air pollution and birth outcomes between January 1, 2015, and December 31, 2017, were collected. Among the 59,868 eligible births, there were 587 stillbirths and 59,281 live births. Although the air quality in this study was relatively better than most of the major cities in China, a positive association was still found between prenatal air pollution exposure and stillbirth rate. Every 10 μg/m3 increase of fine particulate matters (PM2.5) in each trimester, as well as in the entire pregnancy, was associated with increased stillbirth rate (RR = 1.14, 1.11, 1.15, and 1.14 for the first, second, third trimester, and entire pregnancy, respectively). In addition, every 10 μg/m3 increase of PM10 in the first trimester (RR = 1.09, 95% CI: 1.04–1.14), and 10 μg/m3 increase of O3 in the first (RR = 1.05, 95% CI: 1.01–1.09) and third (RR = 1.04, 95% CI: 1.00–1.08) trimesters was also associated with increased stillbirth rate. The effects of PM2.5 on stillbirth rate were found to be robust in the two-pollutant models. The findings of this study especially underscored the adverse effects of prenatal exposure of high levels of PM2.5 on stillbirth. More studies are needed to verify our findings and further investigate the underlying mechanisms.
KeywordsAir pollution Stillbirth Pregnancy Particulate matter Ozone
The authors wish to thank all the investigators in the YMXH system for their help and support of this study.
This work was supported by the Natural Science Foundation of Anhui Province (No. 1708085MH220), the Project Foundation for the Young Talents in Colleges of Anhui Province (No. gxyq2017003), the Grant for Scientific Research of BSKY from Anhui Medical University (No. XJ201621), and the Yancheng Medical Science and Technology Development Program (No. YK2017047).
Compliance with ethical standards
The study was approved by the Institutional Review Board of Anhui Medical University Ethics Committee. All the participants signed informed consents for themselves and their children.
The authors declare that they have no competing interests.
- Chen X, Chen Y, Hou H, Wang D (2012) Relationship between air pollution and perineonate death and birth defects in Tianjin. Guo Ji Fu Chan Ke Xue Za Zhi 39:308–310Google Scholar
- China NBoSo (2011) Communiqué of the National Bureau of Statistics of People’s Republic of China on Major Figures of the 2010 Population Census (No. 1). 2018Google Scholar
- Huang M, Carmichael GR, Pierce RB, Jo DS, Park RJ, Flemming J, Emmons LK, Bowman KW, Henze DK, Davila Y, Sudo K, Jonson JE, Tronstad Lund M, Janssens-Maenhout G, Dentener FJ, Keating TJ, Oetjen H, Payne VH (2017) Impact of intercontinental pollution transport on North American ozone air pollution: an HTAP phase 2 multi-model study. Atmos Chem Phys 17:5721–5750CrossRefGoogle Scholar
- Jing Y, Li M (2000) Association between outdoor air pollution and pregnancy outcomes. In: Guo Wai Yi Xue (Yi Xue Di Li Fen Ce)Google Scholar
- Mendola P, Ha S, Pollack AZ, Zhu Y, Seeni I, Kim SS, Sherman S, Liu D (2017) Chronic and acute ozone exposure in the week prior to delivery is associated with the risk of stillbirth. Int J Environ Res Public Health 14Google Scholar
- National Center for Health Statistics, State Definitions and Reporting Requirements (1997) revision edition. 2018, US Department of Health and Human Services, Centers for Disease Control and Prevention websiteGoogle Scholar
- Patel AB, Meleth S, Pasha O, Goudar SS, Esamai F, Garces AL, Chomba E, McClure EM, Wright LL, Koso-Thomas M, Moore JL, Saleem S, Liechty EA, Goldenberg RL, Derman RJ, Hambidge KM, Carlo WA, Hibberd PL (2015) Impact of exposure to cooking fuels on stillbirths, perinatal, very early and late neonatal mortality—a multicenter prospective cohort study in rural communities in India, Pakistan, Kenya, Zambia and Guatemala. Matern Health Neonatol Perinatol 1:18CrossRefGoogle Scholar
- Qian Z, Liang S, Yang S, Trevathan E, Huang Z, Yang R, Wang J, Hu K, Zhang Y, Vaughn M, Shen L, Liu W, Li P, Ward P, Yang L, Zhang W, Chen W, Dong G, Zheng T, Xu S, Zhang B (2016) Ambient air pollution and preterm birth: a prospective birth cohort study in Wuhan, China. Int J Hyg Environ Health 219:195–203CrossRefGoogle Scholar
- Yang S, Tan Y, Mei H, Wang F, Li N, Zhao J, Zhang Y, Qian Z, Chang JJ, Syberg KM, Peng A, Mei H, Zhang D, Zhang Y, Xu S, Li Y, Zheng T, Zhang B (2018) Ambient air pollution the risk of stillbirth: a prospective birth cohort study in Wuhan, China. Int J Hyg Environ Health 221:502–509CrossRefGoogle Scholar
- Zhu J, Liang J, Mu Y, Li X, Guo S, Scherpbier R, Wang Y, Dai L, Liu Z, Li M, He C, Deng C, Yi L, Deng K, Li Q, Ma X, Wen C, Mu D, Ronsmans C (2016) Sociodemographic and obstetric characteristics of stillbirths in China: a census of nearly 4 million health facility births between 2012 and 2014. Lancet Glob Health 4:e109–e118CrossRefGoogle Scholar