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Maternal exposure to air pollutants and birth weight in Tehran, Iran



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.

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Confidence intervals


High income countries


Low birth weight


Low- and middle-income countries


Land use regression

NO2 :

Nitrogen dioxide


Odds ratios

PM10 :

Particulate matter ≤10 μm in aerodynamic diameter


Standard deviation


Small for gestational age

SO2 :

Sulfur dioxide


Volatile organic compounds


World Health Organization


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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.

Author information

PN prepared the datasets, analyzed the data and interpreted the results and drafted the first version of the manuscript which was supervised by MY. MY, KN, and RN contributed to study design. MY and HK contributed to statistical analysis and results interpretation for the study and assisted in drafting the manuscript. HA contributed to estimate the exposure of study participants to the pollutants with the Land Use Regression model. MY, HK, KN, RN and HA revised it critically for important intellectual content. All authors read and approved the final manuscript.

Correspondence to Homa Kashani or Masud Yunesian.

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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).

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  • Air pollution
  • Nitrogen dioxide
  • Sulfur dioxide
  • Particulate matter
  • Volatile organic compounds
  • Low birth weight