The effect of ambient air pollution on term birth weight and preterm birth in Kansas, 2005-2013 Open Access

Abstract

Epidemiologic studies suggest that exposure to ambient air pollution during pregnancy increases the risk of low birth weight and preterm birth; however, the evidence remains inconsistent. We examined the relationship between ambient levels of particulate matter < 2.5 𝜇𝑚 in diameter (PM2.5), PM2.5 chemical constituents [elemental carbon (EC), organic carbon (OC), and nitrate (NO3), ozone (O3) carbon monoxide (CO), nitrogen dioxide (NO2), and nitrogen oxides (NOx) and two birth outcomes, birth weight and preterm birth, between 2005 and 2013 in Kansas. Using a generalized additive modeling framework, we evaluated relationships between birth weight and pollutant concentrations during the first trimester, second trimester, third trimester, and total pregnancy. For preterm birth, we estimated the risk of preterm for both time-invariant and time-variant exposures with a discrete-time survival model. We also studied the potential modifying effect of pre-pregnancy hypertension, pre-pregnancy diabetes, and infant sex. In this statewide analysis, ambient levels of second- trimester PM2.5, second-trimester O3, total-pregnancy O3, and total-pregnancy PM2.5 were significantly associated with reductions in birth weight [-3.6 to -9.6 g per interquartile range (IQR) increase in pollutant concentrations]. Time-varying total pregnancy NO3 was significantly associated with a 5% decreased risk of preterm birth per IQR increase. These findings suggest some support for an effect of ambient air pollution on term birth weight and preterm birth in Kansas. 

Table of Contents

I. Introduction

II. Methods

i. Study population

ii. Exposure assessment

iii. Statistical analysis

III. Results

IV. Discussion

V. References

VI. Tables

VII. Figures

VIII. Supplementary Tables

About this Master's Thesis

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School	Rollins School of Public Health
Department	Biostatistics
Degree	M.S.P.H.
Submission	Master's Thesis
Language	English
Research Field	Statistics Health Sciences, Epidemiology Environmental Health
Keyword	birth outcomes air pollution
Committee Chair / Thesis Advisor	Howard Chang, PhD, Emory University
Committee Members	Lyndsey Darrow, PhD, University of Nevada, Reno

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