Air Quality, Atmosphere & Health

, Volume 6, Issue 2, pp 455–463 | Cite as

Prenatal ambient air pollution exposure and small for gestational age birth in the Puget Sound Air Basin

  • Sheela SathyanarayanaEmail author
  • Chuan Zhou
  • Carole B. Rudra
  • Tim Gould
  • Tim Larson
  • Jane Koenig
  • Catherine J. Karr


Several studies have identified high concentrations of air pollution as harmful to the developing fetus, but few studies of traffic-derived air pollution and birth outcomes have been conducted in areas of low to moderate air pollution. We identified singleton live births between 1997 and 2005 (N = 367,046 births) in the Puget Sound Air Basin of Washington State. We estimated nitrogen dioxide (NO2) exposure using a land use regression model of traffic, PM2.5 exposure from the nearest community monitor, and proximity to highways/roadways for the residential location of all subjects. Logistic regression estimates of odds ratios (OR) of small for gestational age (SGA) and low birth weight (<2,500 g) among term births were calculated. We observed a modest association between SGA births with increasing quartile of first trimester NO2 exposure: second (OR = 1.01, 95 % confidence interval (CI) 0.97, 1.04), third (OR = 1.06, 95 % CI 1.03, 1.10), and fourth (OR = 1.08, 95 % CI 1.04, 1.12) (p trend <0.001). We did not observe an association between PM2.5 and SGA or low birth weight among term births. Our findings suggest that prenatal exposure to traffic-derived air pollutants has a modest effect on fetal growth in a region with low overall air pollutant concentrations. Given the modest associations, future studies in similar settings that maximize the opportunity to address potential residual confounding are needed.


Air pollution Small for gestational age Low birth weight Traffic 



Body mass index


Confidence interval




Land use regression




Micrograms per cubic meter


Nitric oxide


Nitrogen dioxide


Particulate matter ≤2.5 μm in aerodynamic diameter


Odds ratio


Parts per billion


Standard deviation


Small for gestational age


United States



We acknowledge the Ambulatory Pediatric Association/AHRQ Young Investigator Grant Program which provided funds for this analysis and the Health Canada Border Air Quality Study—Western Pilot Initiative that provided funds for creating the LUR models. British Columbia Centres for Disease Control Agreement. Grant No. GEH0404.

Conflicts of interest

Each author has no conflicts of interest to report.


  1. Aguilera I, Sunyer J et al (2008) Estimation of outdoor NO(x), NO(2), and BTEX exposure in a cohort of pregnant women using land use regression modeling. Environ Sci Technol 42(3):815–821CrossRefGoogle Scholar
  2. Aguilera I, Guxens M et al (2009) Association between GIS-based exposure to urban air pollution during pregnancy and birth weight in the INMA Sabadell Cohort. Environ Health Perspect 117(8):1322–1327Google Scholar
  3. Archive WSGD Metropolitan statistical area expressway, highway, and major road listings (2007) University of Washington. Accessed 2 Sep 2012
  4. Bell ML, Ebisu K et al (2007) Ambient air pollution and low birth weight in Connecticut and Massachusetts. Environ Health Perspect 115(7):1118–1124CrossRefGoogle Scholar
  5. Bobak M (2000) Outdoor air pollution, low birth weight, and prematurity. Environ Health Perspect 108(2):173–176CrossRefGoogle Scholar
  6. Brauer M, Lencar C et al (2008) A cohort study of traffic-related air pollution impacts on birth outcomes. Environ Health Perspect 116(5):680–686CrossRefGoogle Scholar
  7. Dejmek J, Selevan SG et al (1999) Fetal growth and maternal exposure to particulate matter during pregnancy. Environ Health Perspect 107(6):475–480CrossRefGoogle Scholar
  8. DiGiuseppe DL, Aron DC et al (2002) Reliability of birth certificate data: a multi-hospital comparison to medical records information. Matern Child Health J 6(3):169–179CrossRefGoogle Scholar
  9. Glinianaia SV, Rankin J et al (2004) Particulate air pollution and fetal health: a systematic review of the epidemiologic evidence. Epidemiology 15(1):36–45CrossRefGoogle Scholar
  10. Henderson SB, Beckerman B, Jerrett M, Brauer M (2007) Application of land use regression to estimate ambient concentrations of traffic-related NOX and fine particulate matter. Environ Sci Technol 41(7):2422–2428CrossRefGoogle Scholar
  11. Hoyert DL, Mathews TJ et al (2006) Annual summary of vital statistics: 2004. Pediatrics 117(1):168–183CrossRefGoogle Scholar
  12. Keuken M, Roemer M, Elshout S (2009) Trend analysis of urban NO2 concentrations and the importance of direct NO2 emissions versus ozone/NOx equilibrium. Atmos Environ 43:4780–4783CrossRefGoogle Scholar
  13. Leem JH, Kaplan BM et al (2006) Exposures to air pollutants during pregnancy and preterm delivery. Environ Health Perspect 114(6):905–910CrossRefGoogle Scholar
  14. Mar TF, Koenig JQ (2009) Relationship between visits to emergency departments for asthma and ozone exposure in greater Seattle, Washington. Ann Allergy Asthma Immunol 103(6):474–479CrossRefGoogle Scholar
  15. Marshall JD, Nethery E, Brauer M (2008) Within-urban variability in ambient air pollution: comparison of estimation methods. Atmospheric Environment 42(6):1359–1369CrossRefGoogle Scholar
  16. Norris G, Larson T (1999) Spatial and temporal measurements of NO2 in an urban area using continuous mobile monitoring and passive samplers. J Expo Anal Environ Epidemiol 9(6):586–593CrossRefGoogle Scholar
  17. Poplawski K, Gould T et al (2009) Intercity transferability of land use regression models for estimating ambient concentrations of nitrogen dioxide. J Expo Sci Environ Epidemiol 19(1):107–117CrossRefGoogle Scholar
  18. PSCA (2008) 2005 Air emission inventory for King, Kitsap, Pierce, and Snohomish CountiesGoogle Scholar
  19. Puget Sound Clean Air Agency (2006) 2005 air quality data summaryGoogle Scholar
  20. Ritz B, Yu F et al (2000) Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology 11(5):502–511CrossRefGoogle Scholar
  21. Sheppard L, Levy D et al (1999) Effects of ambient air pollution on nonelderly asthma hospital admissions in Seattle, Washington, 1987–1994. Epidemiology 10(1):23–30CrossRefGoogle Scholar
  22. Slama R, Morgenstern V et al (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(9):1283–1292CrossRefGoogle Scholar
  23. Sram RJ, Binkova B et al (2005) Ambient air pollution and pregnancy outcomes: a review of the literature. Environ Health Perspect 113(4):375–382CrossRefGoogle Scholar
  24. USC Bureau (2005) Population estimates for metropolitan, micropolitan, and combined statistical areas available on the US Census Bureau website. O. o. M. a. BudgetGoogle Scholar
  25. Washington State Department of Health (2007) Washington State vital statistics 2005Google Scholar
  26. Wilhelm M, Ritz B (2003) Residential proximity to traffic and adverse birth outcomes in Los Angeles county, California, 1994–1996. Environ Health Perspect 111(2):207–216CrossRefGoogle Scholar
  27. Wilhelm M, Ritz B (2005) Local variations in CO and particulate air pollution and adverse birth outcomes in Los Angeles County, California, USA. Environ Health Perspect 113(9):1212–1221CrossRefGoogle Scholar
  28. Wilhelm M, Ghosh JK et al. (2011) Traffic-related air toxics and term low birth weight in Los Angeles County, California. Environ Health PerspectGoogle Scholar
  29. Woodruff TJ, Parker JD et al (2009) Methodological issues in studies of air pollution and reproductive health. Environ Res 109(3):311–320CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Sheela Sathyanarayana
    • 1
    • 2
    • 5
    Email author
  • Chuan Zhou
    • 2
  • Carole B. Rudra
    • 3
  • Tim Gould
    • 4
  • Tim Larson
    • 4
    • 5
  • Jane Koenig
    • 5
  • Catherine J. Karr
    • 1
    • 5
  1. 1.Department of PediatricsUniversity of WashingtonSeattleUSA
  2. 2.Center for Child Health, Behavior and DevelopmentSeattle Children’s Research InstituteSeattleUSA
  3. 3.Independent HealthBuffaloUSA
  4. 4.Civil and Environmental EngineeringUniversity of WashingtonSeattleUSA
  5. 5.Department of Environmental and Occupational Health SciencesUniversity of WashingtonSeattleUSA

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