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. 2009 Sep;20(5):689-98.
doi: 10.1097/EDE.0b013e3181a7128f.

Ambient air pollution and preterm birth: a time-series analysis

Lyndsey A Darrow  1 , Mitchel Klein, W Dana Flanders, Lance A Waller, Adolfo Correa, Michele Marcus, James A Mulholland, Armistead G Russell, Paige E Tolbert
Affiliations

Ambient air pollution and preterm birth: a time-series analysis

Lyndsey A Darrow et al. Epidemiology. 2009 Sep.

Abstract

Background: An emerging body of evidence suggests that ambient levels of air pollution during pregnancy are associated with preterm birth.

Methods: To further investigate these relationships we used vital record data to construct a retrospective cohort of 476,489 births occurring between 1994 and 2004 in 5 central counties of metropolitan Atlanta. Using a time-series approach, we examined aggregated daily counts of preterm birth in relation to ambient levels of carbon monoxide, nitrogen dioxide, sulfur dioxide, ozone, particulate matter <10 microm in diameter (PM10), particulate matter <2.5 microm in diameter (PM2.5), and speciated PM measurements. Daily pollutant levels in 5-county Atlanta were characterized using a population-weighted spatial average of air quality monitors in the study area. We also examined ambient concentrations at individual monitors in analyses limited to mothers with residential geocodes within 4 miles of each monitor. Relationships between average pollution levels during 3 gestational windows of interest were modeled using Poisson generalized linear models. Results were adjusted for seasonal and long-term time trends.

Results: Although most results were null, there were 3 positive associations between ambient pollution levels and preterm birth in the 4-mile capture-area analyses. Daily preterm birth rates were associated with average NO2 concentrations in the preceding 6 weeks and with average PM2.5 sulfate and PM2.5 water-soluble metal concentrations in the preceding week.

Conclusions: Results provide limited support for late-pregnancy effects of ambient air pollution on preterm birth.

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Figures

Figure 1
Figure 1
Five-county metropolitan Atlanta, population density according to the 2000 Census and location of ambient air quality monitoring stations 1. Indicates Jefferson St. monitoring station (CO, NO2, SO2, O3, PM10, PM2.5, PM components monitored); 2, Georgia Tech (NO2, SO2, PM10); 3, South DeKalb (NO2, O3, PM2.5); 4, Tucker (NO2, PM2.5); 5, Fire Station 8 (PM10, PM2.5); 6, Fulton Health Dept (PM10); 7, Doraville Health Center (PM10, PM2.5); 8, East Rivers School (PM10, PM2.5); 9, Forest Park (PM2.5); 10, Kennesaw (PM2.5); 11, Fort McPherson (PM2.5); 12, Roswell Road (CO); 13, DeKalb Tech (CO); 14, Confederate Ave (SO2, O3).
Figure 2
Figure 2
Monitor-specific adjusted risk ratios (circles) and 95% CIs (vertical bars) for preterm birth associated with a 5 ppb increase in NO2 levels in the preceding six weeks. Adjusted for long term trends, seasonal trends, race/ethnicity, marital status, education, gestational week and interaction between gestational week and maternal characteristics. Monitoring time periods: Georgia Tech 1/94–12/04, Jefferson St. 8/98–12/04, South DeKalb 1/94–12/04, Tucker 4/95–12/04.
See this image and copyright information in PMC

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