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
. 2022 Aug 19;19(16):10365.
doi: 10.3390/ijerph191610365.

Benzene and NO2 Exposure during Pregnancy and Preterm Birth in Two Philadelphia Hospitals, 2013-2017

Kathleen M Escoto  1 , Anne M Mullin  2 , Rachel Ledyard  3 , Elizabeth Rovit  4 , Nancy Yang  3 , Sheila Tripathy  5   6 , Heather H Burris  3   7   8 , Jane E Clougherty  5
Affiliations

Benzene and NO2 Exposure during Pregnancy and Preterm Birth in Two Philadelphia Hospitals, 2013-2017

Kathleen M Escoto et al. Int J Environ Res Public Health. .

Abstract

Infants born preterm are at risk of neonatal morbidity and mortality. Preterm birth (PTB) can be categorized as either spontaneous (sPTB) or medically indicated (mPTB), resulting from distinct pathophysiologic processes such as preterm labor or preeclampsia, respectively. A growing body of literature has demonstrated the impacts of nitrogen dioxide (NO2) and benzene exposure on PTB, though few studies have investigated how these associations may differ by PTB subtype. We investigated the associations of NO2 and benzene exposure with sPTB and mPTB among 18,616 singleton live births at two Philadelphia hospitals between 2013 and 2017. Residential NO2 exposure was estimated using a land use regression model and averaged over the patient's full pregnancy. Benzene exposure was estimated at the census tract level using National Air Toxics Assessment (NATA) exposure data from 2014. We used logistic mixed-effects models to calculate odds ratios for overall PTB, sPTB, and mPTB separately, adjusting for patient- and tract-level confounders. Given the known racial segregation and PTB disparities in Philadelphia, we also examined race-stratified models. Counter to the hypothesis, neither NO2 nor benzene exposure differed by race, and neither were significantly associated with PTB or PTB subtypes. As such, these pollutants do not appear to explain the racial disparities in PTB in this setting.

Keywords: NO2; Philadelphia; benzene; medically indicated preterm birth; nitrogen dioxide; preterm birth; spontaneous preterm birth.

PubMed Disclaimer

Conflict of interest statement

The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Analytic cohort development.
Figure 2
Figure 2
(a) Benzene level by census tract in Philadelphia County; (b) spatial component of LUR model showing NO2. This map does not account for temporal component, which is individualized to the patient.
Figure 3
Figure 3
Number of births per census tract by hospital: (a) Hospital of the University of Pennsylvania; (b) Pennsylvania Hospital.
Figure 4
Figure 4
Maternal race by census tract. (a) Patients who self-identified as Black, Non-Hispanic; (b) Patients who self-identified as White Non-Hispanic.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention Preterm Birth. Reproductive Health 2020. [(accessed on 8 October 2021)]; Available online: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth....
    1. Hack M., Flannery D.J., Schluchter M., Cartar L., Borawski E., Klein N. Outcomes in Young Adulthood for Very-Low-Birth-Weight Infants. N. Engl. J. Med. 2002;346:149–157. doi: 10.1056/NEJMoa010856. - DOI - PubMed
    1. Zwicker J.G., Harris S.R. Quality of Life of Formerly Preterm and Very Low Birth Weight Infants from Preschool Age to Adulthood: A Systematic Review. Pediatrics. 2008;121:e366–e376. doi: 10.1542/peds.2007-0169. - DOI - PubMed
    1. Osterman M.J., Hamilton B.E., Martin J.A., Driscoll A.K., Valenzuela C.P. National Vital Statistics Report. Centers for Disease Control and Prevention; Atlanta, GA, USA: 2021. Births: Final data for 2020; pp. 1–50. - PubMed
    1. Burris H.H., Lorch S.A., Kirpalani H., Pursley D.M., Elovitz M., Clougherty J.E. Racial disparities in preterm birth in USA: A biosensor of physical and social environmental exposures. Arch. Dis. Child. 2019;104:931–935. doi: 10.1136/archdischild-2018-316486. - DOI - PMC - PubMed

Publication types