Acute effects of air pollution on spontaneous abortion, premature delivery, and stillbirth in Ahvaz, Iran: a time-series study

Abstract

Living in areas with high air pollution may have adverse effects on human health. There are few studies about the association between breathing polluted air and adverse pregnancy outcomes in the Middle East. The aim of this study was to determine the relationship between air pollution and spontaneous abortion, premature birth, and stillbirth in Ahvaz. A time-series study was conducted. Data about spontaneous abortion, premature deliveries, and stillbirth was collected from Ahvaz Imam Khomeini Hospital. Air pollution data including NO, CO, NO2, PM10, SO2, O3, and climate data were, respectively, collected from the Environmental Protection Agency and the Khuzestan Province Meteorology Office from March 2008 until March 2015. The relationship between air pollutants with the number of abortions, premature births, and stillbirths was found using a quasi-Poisson distributed lag model, adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holidays. The average daily dust in Ahvaz on 7.2% days of the year was higher than 500 μg/m3 (very dangerous). Findings from this study indicate a significant association between each 10-unit increase in SO2 and spontaneous abortion in lag 0 and 9 days. There was a significant relation between each 10-unit increase in NO2 and CO, and premature birth in lag 0. Also, we found a significant association between each 10-unit increase in CO and premature delivery in lag 1; PM10 and premature delivery in lags 10, 11, and 12; and NO and premature delivery in lags 3, 4, 10, 11, 12, and 13 (p value < 0.05). Contact with polluted air during pregnancy may increase adverse pregnancy outcomes and stillbirth. Pregnant women should avoid polluted air.

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Acknowledgements

The authors thank Mr. Ali Reza Azarian and his colleagues from the Khuzestan Province Environmental Protection Agency (EPA), as well as Ms. Yalda Sabbaghan for their kind assistance. Authors also thank the Ahvaz Jundishapur University of Medical Sciences and particularly the Air Pollution and Respiratory Diseases Research Center for their financial support (Grant No: APRD 9607).

Funding

The present paper was extracted from Research Project No. APRD 9607 approved by the Research Deputy of Ahvaz Jundishapur University of Medical Sciences.

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NK, EI, and GG conceived and designed the project. MD acquired the data. MD analyzed and interpreted the data. NK and MD wrote the paper. All authors commented on and approved the final text.

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Correspondence to Narges Khanjani.

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The authors declare that they have no competing interests.

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Responsible editor: Philippe Garrigues

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Dastoorpoor, M., Idani, E., Goudarzi, G. et al. Acute effects of air pollution on spontaneous abortion, premature delivery, and stillbirth in Ahvaz, Iran: a time-series study. Environ Sci Pollut Res 25, 5447–5458 (2018). https://doi.org/10.1007/s11356-017-0692-9

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Keywords

  • Air pollution
  • Abortion
  • Premature delivery
  • Stillbirth
  • Pregnancy