Exposure to particulate matter and adverse birth outcomes: a comprehensive review and meta-analysis
Increasing number of studies have investigated the impact of maternal exposure to air pollution during pregnancy and adverse birth outcomes, particularly low birth weight (LBW, <2,500 g at birth) and preterm birth (PTB, <37 completed weeks of gestation). We performed a comprehensive review of the peer-reviewed literature and a meta-analysis to quantify the association between maternal exposure to particulate matter with aerodynamic diameter 2.5 and 10 μm (PM2.5 and PM10) during pregnancy and the risk of LBW and PTB. We identified 20 peer-reviewed articles providing quantitative estimate of exposure and outcome that met our selection criteria. There was significant heterogeneity between studies, particularly for findings related to PM10 exposure (LBW, I-squared 54%, p = 0.01; PTB, I-squared = 73%, p < 0.01). Results from random-effect meta-analysis suggested a 9% increase in risk of LBW associated with a 10-μg/m3 increase in PM2.5 (combined odds ratios (OR), 1.09; 95% confidence interval (CI), 0.90–1.32), but our 95% CI included the null value. We estimated a 15% increase in risk of PTB for each 10-μg/m3 increase in PM2.5 (combined OR, 1.15; CI, 1.14–1.16). The magnitude of risk associated with PM10 exposure was smaller (2% per 10-μg/m3 increase) and similar in size for both LBW and PTB, neither reaching formal statistical significance. We observed no significant publication bias, with p > 0.05 based on both Begg's and Egger's bias tests. Our results suggest that maternal exposure to PM, particularly PM2.5 may have adverse effect on birth outcomes. Additional mechanistic studies are needed to understand the underlying mechanisms for this association.
KeywordsAdverse birth outcome Low birth weight (LBW) Preterm birth (PTB) Air pollution Particulate matter Maternal exposure
The views expressed in this paper are those of the authors and do not necessarily reflect the views of the Health Effects Institute or its sponsors.
The work was partially supported by a grant for CHERG to the US Fund for UNICEF and for the Global Burden of Diseases, Injuries, and Risk Factors Study. Both grants were from the Bill & Melinda Gates Foundation.
- Aguilera I, Guxens M, Garcia-Esteban R, Corbella T, Nieuwenhuijsen MJ, Foradada CM, Sunyer J (2009) Association between GIS-based exposure to urban air pollution during pregnancy and birth weight in the INMA Sabadell cohort. Environ Health Perspect 117:1322–1327Google Scholar
- Alderman BW, Baron AE, Savitz DA (1987) Maternal exposure to neighborhood carbon-monoxide and risk of low infant birth-weight. Public Health Rep 102:410–414Google Scholar
- Currie J, Walker R (2009) Traffic congestion and infant health: evidence from E-ZPass. 15413. NBER Working Paper Series. Report. National Bureau of Economic Research, Cambridge, MAGoogle Scholar
- Jalaludin B, Mannes T, Morgan G, Lincoln D, Sheppeard V, Corbett S (2007) Impact of ambient air pollution on gestational age is modified by season in Sydney. Australia, Environmental Health, 6Google Scholar
- Kannan S, Misra DP, Dvonch JT, Krishnakumar A (2006) Exposures to airborne particulate matter and adverse perinatal outcomes: a biologically plausible mechanistic framework for exploring potential effect modification by nutrition. Environ Health Perspect 114:1636–1642Google Scholar
- Maisonet M, Bush TJ, Correa A, Jaakkola JJK (2001) Relation between ambient air pollution and low birth weight in the northeastern United States. Environ Health Perspect 109:351–356Google Scholar
- Olsen J (2005) The Danish national birth cohort—a data source for studying preterm birth. Acta Obstet Gynecol Scand 84:539–540Google Scholar
- Osmond C, Barker DJP (2000) Fetal, infant, and childhood growth are predictors of coronary heart disease, diabetes, and hypertension in adult men and women. Environ Health Perspect 108:545–553Google Scholar
- Pope CA (1996) Particulate pollution and health: a review of the Utah Valley experience. J Expo Anal Environ Epidemiol 6:23–34Google Scholar
- Ricciardi C, Guastadisegni C (2003) Environmental inequities and low birth weight. Ann Ist Super Sanità 39:229–234Google Scholar
- Rudra CB, Williams MA, Frederick IO, Luthy DA (2006) Maternal asthma and risk of preeclampsia—a case-control study. J Reprod Med 51:94–100Google Scholar
- Selevan SG, Kimmel CA, Mendola P (2000) Identifying critical windows of exposure for children's health. Environ Health Perspect 108:451–455Google Scholar
- Slama R, Morgenstern V, Cyrys J, Zutavern A, Herbarth O, Wichmann HE, Heinrich J, LISA Study Group (2007) Traffic-related atmospheric pollutants levels during pregnancy and offspring's term birth weight: a study relying on a land-use regression exposure model. Environ Health Perspect 115:1283–1292CrossRefGoogle Scholar
- Slama R, Thiebaugeorges O, Goua V, Aussel L, Sacco P, Bohet A, Forhan A, Ducot B, Nnesi-Maesano I, Heinrich J, Magnin G, Schweitzer M, Kaminski M, Charles MA (2009) Maternal personal exposure to airborne benzene and intrauterine growth. Environ Health Perspect 117:1313–1321Google Scholar
- Zeger SL, Thomas D, Dominici F, Samet JM, Schwarz J, Dockery D, Cohen A (2001) Exposure measurement error in time-series studies of air pollution: concepts and consequences. Environ Health Perspect 109:A517 (Vol. 108, p 419, 2000)Google Scholar