To examine the associations between the ambient air pollution and early fetal loss.
A retrospective case–control study was conducted. 959 fetal losses and 959 normal intrauterine pregnancies within 14 weeks of pregnancy in 15 general or obstetrics and gynecology hospitals were selected into case and control groups, respectively. Data based on hospital records and national pollution monitor station records were collected. Logistic regression model was conducted to examine the associations between 4 ambient air pollutants (SO2, PM10, NO2 and TSP) exposures and fetal loss.
The ratio of fetal loss to termination of pregnancy for heating months (2.28 %) was significantly (P < 0.001) higher than that for the non-heating months (1.77 %). Logistic regression suggested that fetal loss within 14 weeks was associated with higher exposure to SO2 (OR = 19.76, 95 % CI 2.34–166.71) and TSP (OR = 2.04, 95 % CI 1.01–4.13) in the first month of pregnancy.
Exposure to high levels of SO2 and TSP during the first month of pregnancy was associated with an increased risk of fetal loss in early pregnancy.
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
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Ritz B, Yu F (1999) The effect of ambient carbon monoxide on low birth weight among children born in southern California between 1989 and 1993. Environ Health Perspect 107:17–25
Ritz B, Yu F, Chapa G et al (2000) Effect of air pollution on preterm birth among children born in southern Californiabetween 1989 and 1993. Epidemiology 11:502–511
Ritz B, Yu F, Fruin S et al (2002) Ambient air pollution and risk of birth defects in southern California. Am J Epidemiol 155:17–25
Glinianaia SV, Rankin J, Bell R et al (2004) Particulate air pollution and fetal health: a systematic review of the epidemiologic evidence. Epidemiology 15:36–45
Maisonet M, Correa A, Misra D et al (2004) A review of the literature on the effects of ambient air pollution on fetal growth. Environ Res 95:106–115
Bobak M (1999) Leon DA.Pregnancy outcomes and outdoor air pollution:all ecological study in districts of the Czech Repubhc, 1986–1988. Occup Environ Med 56(8):539–543
Rogers JF, Thompson SJ, Addy CL et al (2000) Association of very low birth weight with exposures to environmental sulfur dioxide and total suspended particulates. Am J Epidemiol 151(6):602–613
Wang X, Ding H, Ryan L et al (1997) Association between air pollution and low birth weight: acommunity-based study. Environ Health Perspect 105(5):514–520
Dug R, Dodds L, Stieb D et al (2006) The association between low level exposures to ambient air pollution and term low birth weight: a retrospective cohort study. Environ Health 5(1):3
Huynh M, Woodruff TJ, Parker JD et al (2006) Relationships between air pollution and preterm birth in California. Paediatr Perinat Epidemiol 20(6):454–461
Liu S, Krewski D, Shi Y et al (2007) Association between maternal exposure to ambient air pollutants during pregnancy and fetal growth restriction. Expo Sci Environ Epidemiol 17(5):426–432
Vassilev ZP, Robson MG, Klotz JB (2001) Association of polycyclic organic matter in outdoor air with decreased birth weight: a pilot cross-sectional analysis. Toxicol Environ Health. 64(8):595–605
Wu J, Hou HY, Chen YQ et al (2010) Exposure to Polycyclic Aromatic Hydrocarbons and Missed abortion in Early Pregnancy in a Chinese Population. Science of the Total Environ 408(11):2313–2318
Astrup P, Olsen HM, Trolle D et al (1972) Effect of moderate carbon monoxide exposure on fetal development. Lancet 2:1220–1222
Mohorovic L (2004) First two months of pregnancy–critical time for preterm delivery and low birthweight caused by adverse effects of coal combustion toxics. Early Hum Dev 80(2):115–123
Sagiv SK, Mendola P, Loomis D, Herring AH, Neas LM, Savitz DA, Poole C (2005) A Time Series Analysis of Air Pollution and Preterm Birth in Pennsylvania, 1997–2001. Environ Health Perspect 113(5):602–606
Perin PM, Maluf M, Czeresnia CE, Januario DA, Saldiva PH (2010) Effects of exposure to high levels of particulate air pollution during the follicular phase of the conception cycle on pregnancy outcome in couples undergoing in vitro fertilization and embryo transfer. Fertil Steril 93(1):301–303
Shahid R, Bertazzon S, Knudtson ML, Ghali WA (2009) Comparison of distance measures in spatial analytical modeling for health service planning. BMC Health Services Research 9:200
Wu J, Wilhelm M, Chung J, Ritz B (2011) Comparing exposure assessment methods for traffic-related air pollution in an adverse pregnancy outcome study. Environ Res 111:685–692
Bobak M, Leon DA (1999) Pregnancy outcomes and outdoor air pollution: an ecological study in districts of the Czech Republic. Occup Environ Med 56:539–543
Ritz B, Yu F (1999) The effect of ambient carbon monoxide on low birth weight among children born in Southern California between 1989 and 1993. Environ Health Perspect 107:17–25
Bobak M (2000) Outdoor pollution, low birth weight, and prematurity. Environ Health Perspect 108:173–176
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(suppl 3):351–356
Ha EH, Hong YC, Lee BE, Woo BH, Schwartz J, Christiani DC (2001) Is air pollution a risk factor for low birth weight in Seoul? Epidemiology. 12:643–648
Lin MC, Yu HS, Tsai SS, Cheng BH, Hsu TY, Wu TN et al (2001) Adverse pregnancy outcome in a petrochemical polluted area in Taiwan. J Toxicol Environ Health 63:565–574
Salam MT, Millstein J, Li Y, Lurmann FW, Margolis HG, Gilliland FD (2005) Birth Outcomes and Prenatal Exposure to Ozone, Carbon Monoxide, and Particulate Matter: results from the Children’s Health Study. Environ Health Perspect 113:1638–1644
Dugandzic R, Dodds L, Stieb D, Smith-Doiron M (2006) The association between low level exposures to ambient air pollution and term low birth weight: a retrospective cohort study. Environ Health. 5:3
Stieb DM, Chen L, Eshoul M, Judek S (2012) Ambient air pollution, birth weight and preterm birth: a systematic review and meta-analysis. Environ Res 117:100–111
Xu X, Ding H, Wang X (1995) Acute effects of total suspended particles and sulfur dioxides on preterm delivery; a communitybased cohort study. Arch Environ Health 50:407–415
Ritz B, Yu F, Chapa G, Fruin S (2000) Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology. 5:502–511
Leem J, Kaplan BM, Shim YK, Pohl HR, Gotway CA, Bullard SM et al (2006) Exposures to Air Pollutants during Pregnancy and Preterm Delivery. Environ Health Perspect 114(6):905–910
Vrijheid M, Martinez D, Manzanares S, Dadvand P, Schembari A, Rankin J, Nieuwenhuijsen M (2011) Ambient Air Pollution and Risk of Congenital Anomalies: a Systematic Review and Meta-analysis. Environ Health Perspect 119(5):598–606
Ritz B, Wilhelm M, Zhao Y (2006) Air Pollution and Infant Death in Southern California, 1989–2000. Pediatricse. 118(2):493–502
Faiz AS, Rhoads GG, Demissie K, Kruse L, Lin Y, Rich DQ (2012) Ambient Air Pollution and the Risk of Stillbirth. Am J Epidemiol 176(4):308–316
Bobak M, Leon DA (1992) Air pollution and infant mortality in the Czech Republic, 1986–1988. Lancet 310:1010–1014
Bobak M, Leon DA (1999) The effect of air pollution on infant mortality appears specific for respiratory causes in the postneonatal period. Epidemiology. 10:666–670
Woodruff T, Grillo J, Schoendorf KC (1997) The relationship between selected causes of postnatal infant mortality and particulate air pollution in the United States. Environ Health Perspect 105:608–612
Loomis D, Castillejos M, Gold RG, McDonnell W, Borja-Aburto VH (1999) Air pollution and infant mortality in Mexico City. Epidemiology. 10:118–123
Xiuju Ma, Wenxia Xiao. Research on missed abortion and oxidative stress.Shanxi medical university paper, 2006;37(2): 202-3
Jauniaux E, Watson AL, Hempstock J et al (2000) matemal arterial blood flow and placental oxidative stress. A possible factoring man early pregnancy failure. Am J Pathol 157(6):2111–2122
Paradisi R, Fabbri R, Battaglia C et al (2007) Nitric oxide levels in women with missed and threatened abortion: results of a pilot study. Fertil Steril 88(3):744–748
Plaisier M, Dennert I, Rost E, Koolwijk P et al (2009) Decidual vascularization and the expression of angiogenic growth factors and proteases in first trimester spontaneous abortions. Hum Reprod 24(1):185–197
The study was supported by Tianjin Science Council (No. 07JCZDJC07400). The authors acknowledge the help from the 15 Hospitals of Tianjin. We especially thank Dr Jun Wu from the California University of USA and the researchers in the Epidemiology Division of the Hospital of Chinese People’s Armed Police Forces for help of study design and data analysis.
Conflict of interest
Y.Q C is an advisor for the research and has nothing to disclose. H.Y.H has nothing to disclose. D.W has nothing to disclose. X.P.Z has nothing to disclose. Z.H.Y has nothing to disclose. T.C.L has nothing to disclose.
About this article
Cite this article
Hou, H.Y., Wang, D., Zou, X.P. et al. Does ambient air pollutants increase the risk of fetal loss? A case–control study. Arch Gynecol Obstet 289, 285–291 (2014). https://doi.org/10.1007/s00404-013-2962-1
- Fetal loss
- Air pollution