Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov 14;18(1):96.
doi: 10.1186/s12940-019-0534-y.

Maternal exposure to ambient fine particulate matter and risk of premature rupture of membranes in Wuhan, Central China: a cohort study

Kun Wang  1 , Yu Tian  2 , Huabo Zheng  1 , Shengshuai Shan  1 , Xiaofang Zhao  1 , Chengyun Liu  3   4
Affiliations

Maternal exposure to ambient fine particulate matter and risk of premature rupture of membranes in Wuhan, Central China: a cohort study

Kun Wang et al. Environ Health. .

Abstract

Background: The associations between maternal exposure to ambient PM2.5 during pregnancy and the risk of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) are controversial. And no relevant study has been conducted in Asia. This study aimed to determine the association between maternal exposure to ambient PM2.5 during pregnancy and the risk of (P)PROM.

Methods: A cohort study including all singleton births in a hospital located in Central China from January 2015 through December 2017 was conducted. Multivariable logistic regression models, stratified analysis, generalized additive model, and two-piece-wise linear regression were conducted to evaluate how exposure to ambient PM2.5 during pregnancy is associated with the risks of PROM and PPROM.

Results: A total of 4364 participants were included in the final analysis, where 11.71 and 2.34% of births were complicated by PROM and PPROM, respectively. The level of PM2.5 exhibited a degree of seasonal variation, and its median concentrations were 63.7, 59.3, 55.8, and 61.8 μg/m3 for the first trimester, second trimester, third trimester, and the whole duration of pregnancy, respectively. After adjustment for potential confounders, PROM was positively associated with PM2.5 exposure (per 10 μg/m3) [Odds Ratio (OR) = 1.14, 95% Confidence Interval (CI), 1.02-1.26 for the first trimester; OR = 1.09, 95% CI, 1.00-1.18 for the second trimester; OR = 1.13, 95% CI, 1.03-1.24 for the third trimester; OR = 1.35, 95% CI, 1.12-1.63 for the whole pregnancy]. PPROM had positive relationship with PM2.5 exposure (per 10 μg/m3) (OR = 1.17, 95% CI, 0.94-1.45 for first trimester; OR = 1.11, 95% CI, 0.92-1.33 for second trimester; OR = 1.19, 95% CI, 0.99-1.44 for third trimester; OR = 1.53, 95% CI, 1.03-2.27 for the whole pregnancy) Positive trends between the acute exposure window (mean concentration of PM2.5 in the last week and day of pregnancy) and risks of PROM and PPROM were also observed.

Conclusions: Exposure to ambient PM2.5 during pregnancy was associated with the risk of PROM and PPROM.

Keywords: Cohort study; Maternal exposure; PM2.5 (airborne particulate matter with an aerodynamic diameter of 0.25 μm or less); PPROM (preterm premature rupture of membranes); PROM (premature rupture of membranes).

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the cohort study
Fig. 2
Fig. 2
Temporal trend of PM2.5 level and quarterly incidence rates of PROM and PPROM from January 2014 to December 2017
Fig. 3
Fig. 3
Smooth curves between the mean concentration of PM2.5 for each trimester and for the whole pregnancy and PROM*. *The orange line represents the association between the mean concentration of PM2.5 during the whole pregnancy and PROM, adjusted for year of birth, season of conception, maternal age, parity, maternal anemia, preeclampsia, gestational diabetes, and history of obstetrical-gynecological pathology (Model I); The purple line represents the association between the mean concentration of PM2.5 during the first trimester and PROM, adjusted for Model I plus mean concentration of PM2.5 in the second and third trimesters; The green line represents the association between the mean concentration of PM2.5 during the second trimester and PROM, adjusted for Model I plus mean concentration of PM2.5 in the first and third trimesters; The blue line represents the association between the mean concentration of PM2.5 during the third trimester and PROM, adjusted for Model I plus mean concentration of PM2.5 in the first and second trimesters
Fig. 4
Fig. 4
Smooth curves between the mean concentration of PM2.5 for each trimester and the whole pregnancy and PPROM*. *The orange line represents the association between the mean concentration of PM2.5 during the whole pregnancy and PPROM, adjusted for year of birth, season of conception, maternal age, parity, maternal anemia, preeclampsia, gestational diabetes, and history of obstetrical-gynecological pathology (Model I); The purple line represents the association between the mean concentration of PM2.5 during the first trimester and PPROM, adjusted for Model I plus mean concentration of PM2.5 in second and third trimesters; The green line represents the association between the mean concentration of PM2.5 during the second trimester and PPROM, adjusted for Model I plus mean concentration of PM2.5 in the first and third trimesters; The blue line represents the association between the mean concentration of PM2.5 during the third trimester and PPROM, adjusted for Model I plus mean concentration of PM2.5 in the first and second trimester
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. ACOG Practice Bulletin No. 188: Prelabor Rupture of Membranes. OBSTET GYNECOL. 2018 2018-01-01;131(1):e1-14. - PubMed
    1. Rouse DJ, Landon M, Leveno KJ, et al. The Maternal-Fetal Medicine Units cesarean registry: chorioamnionitis at term and its duration-relationship to outcomes. Am J Obstet Gynecol. 2004;191(1):211–216. doi: 10.1016/j.ajog.2004.03.003. - DOI - PubMed
    1. Mark SP, Croughan-Minihane MS, Kilpatrick SJ. Chorioamnionitis and uterine function. Obstet Gynecol. 2000;95(6 Pt 1):909–912. - PubMed
    1. Merenstein GB, Weisman LE. Premature rupture of the membranes: neonatal consequences. Semin Perinatol. 1996;20(5):375–380. doi: 10.1016/S0146-0005(96)80004-8. - DOI - PubMed
    1. Major CA, de Veciana M, Lewis DF, Morgan MA. Preterm premature rupture of membranes and abruptio placentae: is there an association between these pregnancy complications? Am J Obstet Gynecol. 1995;172(2 Pt 1):672–676. doi: 10.1016/0002-9378(95)90591-X. - DOI - PubMed

Publication types

Supplementary concepts