Air pollution can cause various health outcomes, especially in susceptible groups including pregnant women. Low birth weight (LBW) is among the adverse birth outcomes and is one of the main causes of infant mortality. The aim of this study was to assess the association between air pollutants and LBW in Tehran, Iran.
In this case-control study, 2144 babies born in three hospitals of Tehran (Iran) during 2011 to 2012 whose mothers were the residents of this city in last 5 years were considered. Of these, 468 infants with birth weight < 2500 g and 1676 with birth weight ≥ 2500 g were regarded as case and control groups, respectively. Gestational age was also considered for definition of cases (small for gestational age (SGA)) and controls (appropriate for gestational age). Land use regression models were used to assess exposure to particulate matter ≤10 μm in aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2) and volatile organic compounds (benzene, toluene, ethylbenzene, o-xylene, m-xylene, p-xylene (BTEX), and total BTEX) during pregnancy. Logistic regression model was applied to assess the association between air pollutants and LBW.
The concentrations of air pollutants were very high but similar in cases and controls. After adjustment for potential confounding variables, no statistically significant association was observed between air pollutants and LBW. The adjusted odds ratios (95% confidence interval) for PM10, SO2, and benzene were 0.999 (0.994–1.005), 0.998 (0.993–1.003), and 0.980 (0.901–1.067), respectively.
No association was found between LBW and air pollutants. Further studies with more rigorous designs and access to more comprehensive information are suggested to assess the effect of other air pollutants, such as CO, O3, PM2.5, ultrafine particles, and oxidative potential of particles on birth outcomes.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
High income countries
Low birth weight
Low- and middle-income countries
Land use regression
- NO2 :
- PM10 :
Particulate matter ≤10 μm in aerodynamic diameter
Small for gestational age
- SO2 :
Volatile organic compounds
World Health Organization
Laumbach RJ. Outdoor air pollutants and patient health. Am Fam Physician. 2010;81(2):175–80.
Dominici F, Peng RD, Bell ML, Pham L, McDermott A, Zeger SL, et al. Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. Jama. 2006;295(10):1127–34.
van den Hooven EH, Pierik FH, de Kluizenaar Y, Hofman A, van Ratingen SW, Zandveld PY, et al. Air pollution exposure and markers of placental growth and function: the generation R study. Environ Health Perspect. 2012;120(12):1753–9.
Proietti E, Röösli M, Frey U, Latzin P. Air pollution during pregnancy and neonatal outcome: a review. Journal of aerosol medicine and pulmonary drug delivery. 2013;26(1):9–23.
Wardlaw TM, Blanc A, Zupan J, Ahman E. Low birthweight: country, regional and global estimates. UNICEF,United Nation’s Children’s fund and World Health; 2004.
WHO. World Health Statistics http://www.who.int/gho/publications/world_health_statistics/2015/en. 2015. Accessed 7 June 2019.
Singh G, Chouhan R, Sidhu K. Maternal factors for low birth weight babies. Medical journal, Armed Forces India. 2009;65(1):10–2.
Tofail F, Hamadani J, Ahmed A, Mehrin F, Hakim M, Huda S. The mental development and behavior of low-birth-weight Bangladeshi infants from an urban low-income community. Eur J Clin Nutr. 2012;66(2):237–43.
Barker DJ. The origins of the developmental origins theory. J Intern Med. 2007;261(5):412–7.
Triche EW, Hossain N. Environmental factors implicated in the causation of adverse pregnancy outcome. Semin Perinatol. 2007;31:240–2.
Šrám RJ, Binková B, Dejmek J, Bobak M. Ambient air pollution and pregnancy outcomes: a review of the literature. Environ Health Perspect. 2005;113(4):375–82.
Llop S, Ballester F, Estarlich M, Esplugues A, Rebagliato M, Iñiguez C. Preterm birth and exposure to air pollutants during pregnancy. Environ Res. 2010;110(8):778–85.
Stieb DM, Chen L, Eshoul M, Judek S. Ambient air pollution, birth weight and preterm birth: a systematic review and meta-analysis. Environ Res. 2012;117:100–11.
Slama R, Darrow L, Parker J, Woodruff TJ, Strickland M, Nieuwenhuijsen M, et al. Meeting report: atmospheric pollution and human reproduction. Environ Health Perspect. 2008;116(6):791–8.
Kannan S, Misra DP, Dvonch JT, Krishnakumar A. Exposures to airborne particulate matter and adverse perinatal outcomes: a biologically plausible mechanistic framework for exploring potential effect modification by nutrition. Environ Health Perspect. 2006;114(11):1636–42.
Bell ML, Ebisu K, Belanger K. Ambient air pollution and low birth weight in Connecticut and Massachusetts. Environ Health Perspect. 2007;115(7):1118–24.
Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012;186(11):1095–101.
Chen T-M, Kuschner WG, Gokhale J, Shofer S. Outdoor air pollution: nitrogen dioxide, sulfur dioxide, and carbon monoxide health effects. Am J Med Sci. 2007;333(4):249–56.
Nguyen HT, Kim K-H, Kim M-Y. Volatile organic compounds at an urban monitoring station in Korea. J Hazard Mater. 2009;161(1):163–74.
Tunsaringkarn T, Siriwong W, Rungsiyothin A, Nopparatbundit S. Occupational exposure of gasoline station workers to BTEX compounds in Bangkok, Thailand. The international journal of occupational and environmental medicine. 2012;3:117–25.
Van de Kant KD, van der Sande LJ, Jöbsis Q, van Schayck OC, Dompeling E. Clinical use of exhaled volatile organic compounds in pulmonary diseases: a systematic review. Respir Res. 2012;13(1):117.
Aguilera I, Guxens M, Garcia-Esteban R, Corbella T, Nieuwenhuijsen MJ, Foradada CM, et al. Association between GIS-based exposure to urban air pollution during pregnancy and birth weight in the INMA Sabadell cohort. Environ Health Perspect. 2009;117(8):1322–7.
Estarlich M, Ballester F, Aguilera I, Fernández-Somoano A, Lertxundi A, Llop S, et al. Residential exposure to outdoor air pollution during pregnancy and anthropometric measures at birth in a multicenter cohort in Spain. Environ Health Perspect. 2011;119(9):1333–8.
Slama R, Thiebaugeorges O, Goua V, Aussel L, Sacco P, Bohet A, et al. Maternal personal exposure to airborne benzene and intrauterine growth. Environ Health Perspect. 2009;117(8):1313–21.
Badham HJ, Winn LM. In utero and in vitro effects of benzene and its metabolites on erythroid differentiation and the role of reactive oxygen species. Toxicol Appl Pharmacol. 2010;244(3):273–9.
Slama R, Morgenstern V, Cyrys J, Zutavern A, Herbarth O, Wichmann H-E, et al. 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. 2007;115(9):1283–92.
Junger WL, Ponce de Leon A. Air pollution and low birth weight in the city of Rio de Janeiro, Brazil, 2002. Cadernos de Saúde Pública. 2007;23:588–98.
Madsen C, Gehring U, Walker SE, Brunekreef B, Stigum H, Næss Ø, et al. Ambient air pollution exposure, residential mobility and term birth weight in Oslo. Norway Environmental research. 2010;110(4):363–71.
Marshall JD, Nethery E, Brauer M. Within-urban variability in ambient air pollution: comparison of estimation methods. Atmos Environ. 2008;42(6):1359–69.
Gehring U, van Eijsden M, Dijkema MB, van der Wal MF, Fischer P, Brunekreef B. Traffic-related air pollution and pregnancy outcomes in the Dutch ABCD birth cohort study. Occup Environ Med. 2011;68(1):36–43.
Amini H, Yunesian M, Hosseini V, Schindler C, Henderson SB, Künzli N. A systematic review of land use regression models for volatile organic compounds. Atmos Environ. 2017;171:1–16.
Amini H, Hosseini V, Schindler C, Hassankhany H, Yunesian M, Henderson SB, et al. Spatiotemporal description of BTEX volatile organic compounds in a middle eastern megacity: Tehran study of exposure prediction for environmental Health Research (Tehran SEPEHR). Environ Pollut. 2017;226:219–29.
Amini H, Taghavi-Shahri SM, Henderson SB, Naddafi K, Nabizadeh R, Yunesian M. Land use regression models to estimate the annual and seasonal spatial variability of sulfur dioxide and particulate matter in Tehran, Iran. Sci Total Environ. 2014;488:343–53.
Amini H, Taghavi-Shahri S-M, Henderson SB, Hosseini V, Hassankhany H, Naderi M, et al. Annual and seasonal spatial models for nitrogen oxides in Tehran, Iran. Sci Rep. 2016;6:32970.
Amini H, Schindler C, Hosseini V, Yunesian M, Künzli N. Land use regression models for Alkylbenzenes in a middle eastern megacity: Tehran study of exposure prediction for environmental Health Research (Tehran SEPEHR). Environmental Science & Technology. 2017;51(15):8481–90.
Morello-Frosch R, Jesdale BM, Sadd JL, Pastor M. Ambient air pollution exposure and full-term birth weight in California. Environ Health. 2010;9(1):44.
Ballester F, Estarlich M, Iñiguez C, Llop S, Ramón R, Esplugues A, et al. Air pollution exposure during pregnancy and reduced birth size: a prospective birth cohort study in Valencia. Spain Environmental Health. 2010;9(1):6.
Liu S, Krewski D, Shi Y, Chen Y, Burnett RT. Association between gaseous ambient air pollutants and adverse pregnancy outcomes in Vancouver, Canada. Environ Health Perspect. 2003;111(14):1773–8.
van den Hooven EH, Jaddoe VW, de Kluizenaar Y, Hofman A, Mackenbach JP, Steegers EA, et al. Residential traffic exposure and pregnancy-related outcomes: a prospective birth cohort study. Environ Health. 2009;8(1):59.
Mannes T, Jalaludin B, Morgan G, Lincoln D, Sheppeard V, Corbett S. Impact of ambient air pollution on birth weight in Sydney, Australia. Occup Environ Med. 2005;62(8):524–30.
Xu X, Sharma RK, Talbott EO, Zborowski JV, Rager J, Arena VC, et al. PM10 air pollution exposure during pregnancy and term low birth weight in Allegheny County, PA, 1994–2000. Int Arch Occup Environ Health. 2011;84(3):251–7.
Nascimento LFC, Moreira DA. Are environmental pollutants risk factors for low birth weight? Cadernos de Saúde Pública. 2009;25(8):1791–6.
Dugandzic R, Dodds L, Stieb D, Smith-Doiron M. The association between low level exposures to ambient air pollution and term low birth weight: a retrospective cohort study. Environ Health. 2006;5(1):3.
Bell ML, Belanger K, Ebisu K, Gent JF, Lee HJ, Koutrakis P, et al. Prenatal exposure to fine particulate matter and birth weight: variations by particulate constituents and sources. Epidemiology (Cambridge, Mass). 2010;21(6):884–91.
Woodruff TJ, Parker JD, Darrow LA, Slama R, Bell ML, Choi H, et al. Methodological issues in studies of air pollution and reproductive health. Environ Res. 2009;109(3):311–20.
Wang R, Henderson SB, Sbihi H, Allen RW, Brauer M. Temporal stability of land use regression models for traffic-related air pollution. Atmos Environ. 2013;64:312–9.
This study was financially supported by the Institute for Environmental Research (IER) of Tehran University of Medical Sciences (grant number 92-01-46-22330). We thank the relevant hospitals (Imam Khomeini, Arash, and Yas) and centers for providing necessary information. We also thank Ms. Masoumeh Mahmoodi for helping us with data collection.
Ethics approval and consent to participate
Consent for publication
Conflict of interest
The authors declare that they have no conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Nakhjirgan, P., Kashani, H., Naddafi, K. et al. Maternal exposure to air pollutants and birth weight in Tehran, Iran. J Environ Health Sci Engineer 17, 711–717 (2019). https://doi.org/10.1007/s40201-019-00386-7
- Air pollution
- Nitrogen dioxide
- Sulfur dioxide
- Particulate matter
- Volatile organic compounds
- Low birth weight