Maternal and Child Health Journal

, Volume 17, Issue 3, pp 545–555 | Cite as

First Trimester Exposure to Ambient Air Pollution, Pregnancy Complications and Adverse Birth Outcomes in Allegheny County, PA

  • Pei-Chen Lee
  • James M. Roberts
  • Janet M. Catov
  • Evelyn O. Talbott
  • Beate Ritz


Despite numerous studies of air pollution and adverse birth outcomes, few studies have investigated preeclampsia and gestational hypertension, two pregnancy disorders with serious consequences for both mother and infant. Relying on hospital birth records, we conducted a cohort study identifying 34,705 singleton births delivered at Magee-Women’s Hospital in Pittsburgh, PA between 1997 and 2002. Particle (<10 μm-PM10; <2.5 μm-PM2.5) and ozone (O3) exposure concentrations in the first trimester of pregnancy were estimated using the space–time ordinary Kriging interpolation method. We employed multiple logistic regression estimate associations between first trimester exposures and preeclampsia, gestational hypertension, preterm delivery, and small for gestational age (SGA) infants. PM2.5 and O3 exposures were associated with preeclampsia (adjusted OR = 1.15, 95 % CI = 0.96–1.39 per 4.0 μg/m3 increase in PM2.5; adjusted OR = 1.12, 95 % CI = 0.89–1.42 per 16.8 ppb increase in O3), gestational hypertension (for PM2.5 OR = 1.11, 95 % CI = 1.00–1.23; for O3 OR = 1.12, 95 % CI = 0.97–1.29), and preterm delivery (for PM2.5 ORs = 1.10, 95 % CI = 1.01–1.20; for O3 ORs = 1.23, 95 % CI = 1.01–1.50). Smaller 5–8 % increases in risk were also observed for PM10 with gestational hypertension and SGA, but not preeclampsia. Our data suggest that first trimester exposure to particles, mostly PM2.5, and ozone, may increase the risk of developing preeclampsia and gestational hypertension, as well as preterm delivery and SGA.


Air pollution Particulate Preeclampsia Gestational hypertension Preterm Small for gestational age (SGA) 


  1. 1.
    Sibai, B., Dekker, G., & Kupferminc, M. (2005). Pre-eclampsia. Lancet, 365(9461), 785–799. doi: 10.1016/s0140-6736(05)17987-2.PubMedGoogle Scholar
  2. 2.
    Goldenberg, R. L., & Rouse, D. J. (1998). Prevention of premature birth. New England Journal of Medicine, 339(5), 313–320. doi: 10.1056/nejm199807303390506.PubMedCrossRefGoogle Scholar
  3. 3.
    Roberts, J. M., & Gammill, H. S. (2005). Preeclampsia: recent insights. Hypertension, 46(6), 1243–1249. doi: 10.1161/01.HYP.0000188408.49896.c5.PubMedCrossRefGoogle Scholar
  4. 4.
    Arias, F., Rodriquez, L., Rayne, S. C., et al. (1993). Maternal placental vasculopathy and infection: two distinct subgroups among patients with preterm labor and preterm ruptured membranes. American Journal of Obstetrics and Gynecology, 168(2), 585–591.PubMedGoogle Scholar
  5. 5.
    Khong, T. Y., De Wolf, F., Robertson, W. B., et al. (1986). Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. British Journal of Obstetrics and Gynaecology, 93(10), 1049–1059.PubMedCrossRefGoogle Scholar
  6. 6.
    Bonzini, M., Carugno, M., Grillo, P., et al. (2010). Impact of ambient air pollution on birth outcomes: systematic review of the current evidences. Medicina del Lavoro, 101(5), 341–363.PubMedGoogle Scholar
  7. 7.
    Ritz, B., Wilhelm, M., Hoggatt, K. J., et al. (2007). Ambient air pollution and preterm birth in the environment and pregnancy outcomes study at the University of California, Los Angeles. American Journal of Epidemiology, 166(9), 1045–1052. doi: 10.1093/aje/kwm181.PubMedCrossRefGoogle Scholar
  8. 8.
    Sram, R. J., Binkova, B., Dejmek, J., et al. (2005). Ambient air pollution and pregnancy outcomes: a review of the literature. Environmental Health Perspectives, 113(4), 375–382.PubMedCrossRefGoogle Scholar
  9. 9.
    Wilhelm, M., & Ritz, B. (2003). Residential proximity to traffic and adverse birth outcomes in Los Angeles county, California, 1994-1996. Environmental Health Perspectives, 111(2), 207–216.PubMedCrossRefGoogle Scholar
  10. 10.
    Rudra, C. B., Williams, M. A., Sheppard, L., et al. (2011). Ambient carbon monoxide and fine particulate matter in relation to preeclampsia and preterm delivery in Western Washington State. Environmental Health Perspectives. doi: 10.1289/ehp.1002947.PubMedGoogle Scholar
  11. 11.
    Woodruff T, Morello-Frosch R, Jesdale B (2008) Air pollution and preeclampsia among pregnant women in California, 1996–2004 Epidemiology p S310.Google Scholar
  12. 12.
    Wu, J., Ren, C., Delfino, R. J., et al. (2009). Association between local traffic-generated air pollution and preeclampsia and preterm delivery in the south coast air basin of California. Environmental Health Perspectives, 117(11), 1773–1779. doi: 10.1289/ehp.0800334.PubMedCrossRefGoogle Scholar
  13. 13.
    van den Hooven, E. H., Jaddoe, V. W., de Kluizenaar, Y., et al. (2009). Residential traffic exposure and pregnancy-related outcomes: a prospective birth cohort study. Environ Health, 8, 59. doi: 10.1186/1476-069x-8-59.PubMedCrossRefGoogle Scholar
  14. 14.
    van den Hooven, E. H., de Kluizenaar, Y., Pierik, F. H., et al. (2011). Air pollution, blood pressure, and the risk of hypertensive complications during pregnancy: the generation R study. Hypertension. doi: 10.1161/HYPERTENSIONAHA.110.164087.PubMedGoogle Scholar
  15. 15.
    Williams, R. L., Creasy, R. K., Cunningham, G. C., et al. (1982). Fetal growth and perinatal viability in California. Obstetrics and Gynecology, 59(5), 624–632.PubMedGoogle Scholar
  16. 16.
    Bodnar, L. M., & Simhan, H. N. (2008). The prevalence of preterm birth and season of conception. Paediatric and Perinatal Epidemiology, 22(6), 538–545. doi: 10.1111/j.1365-3016.2008.00971.x.PubMedCrossRefGoogle Scholar
  17. 17.
    Lee, P. C., Talbott, E. O., Roberts, J. M., et al. (2011). Particulate air pollution exposure and C-reactive protein during early pregnancy. Epidemiology. doi: 10.1097/EDE.0b013e31821c6c58.Google Scholar
  18. 18.
    DeCesare, L., Myers, D. E., & Posa, D. (2001). Product-sum covariance for space-time modeling: an environmental application. Envirometrics, 12, 11–23.CrossRefGoogle Scholar
  19. 19.
    Bell, M. L., Ebisu, K., & Belanger, K. (2007). Ambient air pollution and low birth weight in Connecticut and Massachusetts. Environmental Health Perspectives, 115(7), 1118–1124. doi: 10.1289/ehp.9759.PubMedCrossRefGoogle Scholar
  20. 20.
    Mickey, R. M., & Greenland, S. (1989). The impact of confounder selection criteria on effect estimation. American Journal of Epidemiology, 129(1), 125–137.PubMedGoogle Scholar
  21. 21.
    Harskamp, R. E., & Zeeman, G. G. (2007). Preeclampsia: at risk for remote cardiovascular disease. American Journal of the Medical Sciences, 334(4), 291–295. doi: 10.1097/MAJ.0b013e3180a6f094.PubMedCrossRefGoogle Scholar
  22. 22.
    Mongraw-Chaffin, M. L., Cirillo, P. M., & Cohn, B. A. (2010). Preeclampsia and cardiovascular disease death: prospective evidence from the child health and development studies cohort. Hypertension, 56(1), 166–171. doi: 10.1161/hypertensionaha.110.150078.PubMedCrossRefGoogle Scholar
  23. 23.
    Bobak, M. (2000). Outdoor air pollution, low birth weight, and prematurity. Environmental Health Perspectives, 108(2), 173–176.PubMedCrossRefGoogle Scholar
  24. 24.
    Ritz, B., Yu, F., Chapa, G., et al. (2000). Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology, 11(5), 502–511.PubMedCrossRefGoogle Scholar
  25. 25.
    Sagiv, S. K., Mendola, P., Loomis, D., et al. (2005). A time-series analysis of air pollution and preterm birth in Pennsylvania, 1997-2001. Environmental Health Perspectives, 113(5), 602–606.PubMedCrossRefGoogle Scholar
  26. 26.
    Zhao, Q., Liang, Z., Tao, S., et al. (2011). Effects of air pollution on neonatal prematurity in Guangzhou of China: a time-series study. Environ Health, 10, 2. doi: 10.1186/1476-069x-10-2.PubMedCrossRefGoogle Scholar
  27. 27.
    Dejmek, J., Solansky, I., Benes, I., et al. (2000). The impact of polycyclic aromatic hydrocarbons and fine particles on pregnancy outcome. Environmental Health Perspectives, 108(12), 1159–1164.PubMedCrossRefGoogle Scholar
  28. 28.
    Sram, R. J., Binkova, B., Rossner, P., et al. (1999). Adverse reproductive outcomes from exposure to environmental mutagens. Mutation Research, 428(1–2), 203–215.PubMedCrossRefGoogle Scholar
  29. 29.
    Hansen, C., Neller, A., Williams, G., et al. (2007). Low levels of ambient air pollution during pregnancy and fetal growth among term neonates in Brisbane, Australia. Environmental Research, 103(3), 383–389. doi: 10.1016/j.envres.2006.06.010.PubMedCrossRefGoogle Scholar
  30. 30.
    Parker, J. D., Rich, D. Q., Glinianaia, S. V., et al. (2011). The international collaboration on air pollution and pregnancy outcomes: initial results. Environmental Health Perspectives, 119(7), 1023–1028. doi: 10.1289/ehp.1002725.PubMedCrossRefGoogle Scholar
  31. 31.
    Ros, H. S., Cnattingius, S., & Lipworth, L. (1998). Comparison of risk factors for preeclampsia and gestational hypertension in a population-based cohort study. American Journal of Epidemiology, 147(11), 1062–1070.PubMedCrossRefGoogle Scholar
  32. 32.
    Villar, J., Carroli, G., Wojdyla, D., et al. (2006). Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions? American Journal of Obstetrics and Gynecology, 194(4), 921–931. doi: 10.1016/j.ajog.2005.10.813.PubMedCrossRefGoogle Scholar
  33. 33.
    Kannan, S., Misra, D. P., Dvonch, J. T., et al. (2006). Exposures to airborne particulate matter and adverse perinatal outcomes: a biologically plausible mechanistic framework for exploring potential effect modification by nutrition. Environmental Health Perspectives, 114(11), 1636–1642.PubMedGoogle Scholar
  34. 34.
    Slama, R., Darrow, L., Parker, J., et al. (2008). Meeting report: atmospheric pollution and human reproduction. Environmental Health Perspectives, 116(6), 791–798. doi: 10.1289/ehp.11074.PubMedCrossRefGoogle Scholar
  35. 35.
    Auchincloss, A. H. (2008). Associations between recent exposure to ambient fine particulate matter and blood pressure in the Multi-ethnic Study of Atherosclerosis (MESA). Environmental Health Perspectives, 116(4), 486–491. doi: 10.1289/ehp.10899.PubMedGoogle Scholar
  36. 36.
    Zanobetti, A., Canner, M. J., Stone, P. H., et al. (2004). Ambient pollution and blood pressure in cardiac rehabilitation patients. Circulation, 110(15), 2184–2189. doi: 10.1161/01.CIR.0000143831.33243.D8.PubMedCrossRefGoogle Scholar
  37. 37.
    Sergio Chiarelli P, Amador Pereira LA, Nascimento Saldiva PH, et al. (2011) The association between air pollution and blood pressure in traffic controllers in Santo Andre, Sao Paulo, Brazil. Environ Res doi: 10.1016/j.envres.2011.04.007.
  38. 38.
    Chen, L., Bell, E. M., Caton, A. R., et al. (2010). Residential mobility during pregnancy and the potential for ambient air pollution exposure misclassification. Environmental Research, 110(2), 162–168. doi: 10.1016/j.envres.2009.11.001.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Pei-Chen Lee
    • 1
    • 3
  • James M. Roberts
    • 1
    • 2
  • Janet M. Catov
    • 1
    • 2
  • Evelyn O. Talbott
    • 1
  • Beate Ritz
    • 3
  1. 1.Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  2. 2.Department of Obstetrics and Gynecology, School of MedicineUniversity of PittsburghPittsburghUSA
  3. 3.Department of Epidemiology, School of Public HealthUniversity of California at Los AngelesLos AngelesUSA

Personalised recommendations